{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,4]],"date-time":"2026-09-04T18:58:15Z","timestamp":1788548295894,"version":"build-2803163510"},"reference-count":20,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T00:00:00Z","timestamp":1751846400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T00:00:00Z","timestamp":1751846400000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. pediatr. gastroenterol. nutr."],"published-print":{"date-parts":[[2025,9]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>European Society for Pediatric Gastroenterology, Hepatology, and Nutrition (ESPGHAN) guidelines recommend first\u2010line serology for suspected celiac disease (CeD), measuring only transglutaminase antibodies (TGA\u2010immunoglobulin A [IgA]) plus total IgA. If TGA\u2010IgA is \u226510 times the normal value, pediatric gastroenterologists (pedGI) may diagnose CeD without biopsies if autoantibodies against endomysial antibodies (EMA\u2010IgA) are positive in a 2nd blood sample. This Quality\u2010of\u2010Care (QoC) project benchmarked diagnostic workup in clinical practice using ESPGHAN CeD guidelines as reference.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A pseudonymized survey on CeD practices was sent to 141 hospitals within the ESPGHAN QoC\u2010network in 28 countries.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Questionnaires were completed by 129\/141 (91.5%) hospitals, with 121 (94%) having pedGI staff. As reasons conflicting with good QoC for CeD in their setting, responders assumed knowledge deficits among the public (57%), primary care providers (64%), non\u2010GI physicians (16%), and pedGIs (0%). For initial testing, 66% of physicians ordered only total IgA and TGA\u2010IgA, 7% did not use this combination, and 29% ordered additional serology (TGA\u2010IgG, EMA, antibodies against deaminated gliadin peptide, or native gliadin). Regarding conflicting results for TGA\u2010IgA and histopathology in IgA\u2010sufficient children, 61% incorrectly classified negative TGA\u2010IgA with Marsh 2 and 57% with Marsh 3 lesions as \u201cpotential CeD,\u201d while 49% excluded CeD in the case of villous atrophy and negative TGA\u2010IgA. Routine practice did not align with the ESPGHAN recommendations regarding performance of duodenal biopsies (27%), EMA\u2010testing (34%), and diagnosis of CeD in IgA\u2010deficient children (32%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>We identified areas for improving QoC regarding both effectiveness and efficacy, in pediatric patients with suspected CeD, and consequently developed easy\u2010to\u2010use tools to improve guideline implementation.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/jpn3.70143","type":"journal-article","created":{"date-parts":[[2025,7,7]],"date-time":"2025-07-07T05:20:02Z","timestamp":1751865602000},"page":"606-617","source":"Crossref","is-referenced-by-count":3,"title":["Celiac disease diagnosis in clinical practice: ESPGHAN quality of care survey from 129 pediatric hospitals across 28 countries"],"prefix":"10.1002","volume":"81","author":[{"given":"Anna","family":"Litwin","sequence":"first","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Gastroenterology and Hepatology, Dr. von Hauner Children's Hospital LMU University Hospital Munich LMU Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Thu Giang","family":"Le Thi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Gastroenterology and Hepatology, Dr. von Hauner Children's Hospital LMU University Hospital Munich LMU Munich Munich Germany"},{"name":"Stiftung Kindergesundheit, c\/o Dr. von Hauner Children's Hospital LMU University Hospital Munich LMU Munich Munich Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nabil","family":"El\u2010Lababidi","sequence":"additional","affiliation":[{"name":"Department of Pediatrics and Inherited Metabolic Disorders, First Faculty of Medicine Charles University and General University Hospital Prague Czech Republic"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Angelika","family":"Kindermann","sequence":"additional","affiliation":[{"name":"Department of Pediatric Gastroenterology, Hepatology, and Nutrition Emma Children's Hospital, Amsterdam UMC Amsterdam The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rouzha","family":"Pancheva","sequence":"additional","affiliation":[{"name":"Department of Hygiene and Epidemiology, Faculty of Public Health Prof. Paraskev Stoyanov Medical University Varna Bulgaria"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Konstantinos","family":"Gerasimidis","sequence":"additional","affiliation":[{"name":"Human Nutrition, School of Medicine University of Glasgow Glasgow United Kingdom of Great Britain and Northern Ireland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cristina Campos","family":"Goncalves","sequence":"additional","affiliation":[{"name":"Central Lisbon University Hospital Centre Lisbon Portugal"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paula Crespo","family":"Escobar","sequence":"additional","affiliation":[{"name":"i+HeALTH Strategic Research Group, Department of Health Sciences Miguel de Cervantes European University (UEMC) Valladolid Spain"},{"name":"Unit of Nutrition and Obesity Hospital Recoletas Campo Grande Valladolid Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tena","family":"Niseteo","sequence":"additional","affiliation":[{"name":"Referral Center for Pediatric Gastroenterology and Nutrition Children's Hospital Zagreb Zagreb Croatia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katharina","family":"Ikrath","sequence":"additional","affiliation":[{"name":"The European Society for Paediatric Gastroenterology, Hepatology, and Nutrition Geneva Switzerland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2374-8778","authenticated-orcid":false,"given":"Sibylle","family":"Koletzko","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Division of Pediatric Gastroenterology and Hepatology, Dr. von Hauner Children's Hospital LMU University Hospital Munich LMU Munich Munich Germany"},{"name":"Department of Pediatrics, Gastroenterology and Nutrition School of Medicine Collegium Medicum University of Warmia and Mazury Olsztyn Poland"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"for the Quality\u2010of\u2010Care 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