Physician Review of a Celiac Disease Risk Estimation and Decision-Making Expert System

Robert L. Pastore, Joseph A. Murray, Frederick D. Coffman, Antonina Mitrofanova, Shankar Srinivasan

Research output: Contribution to journalArticlepeer-review


Objective: Celiac disease is a genetic disease affecting people of all ages, resulting in small intestine enteropathy. It is considered to be a clinical chameleon. Average prevalence of celiac disease is 1 out of 100 people with data indicating the risk may be as high as 22% for those with first-degree relatives with the disease. Eighty-three percent of people with celiac disease may be undiagnosed. Average duration to diagnosis is 10 years. Data indicate that there is a lack of consensus regarding diagnostics and symptomatology. Method: A clinical decision support system (CDSS) was developed using Exsys Corvid for expert analysis (CD-CDSS). The CD-CDSS was divided into symptoms and manifestations with 80 points of navigation, and a serology section, and was validated by 13 experts in the field of celiac disease using a 10-statement 5-point Likert scale. Results: This scale was analyzed using Cronbach’s alpha reliability coefficient, which was calculated using SPSS and revealed good internal consistency and reliability with a result of 0.813. One hundred percent of experts agreed that the CD-CDSS is capable of guiding a health care professional through the diagnostic process, contains an accurate list of symptoms based on the clinical literature, and can foster improved awareness and education about celiac disease and that there is a need for this system. Conclusions: A celiac disease risk estimation and decision-making expert system was successfully developed and evaluated by medical professionals, with 100% agreeing that this CD-CDSS is medically accurate and can guide health care professionals through the diagnostic process.

Original languageEnglish (US)
Pages (from-to)722-728
Number of pages7
JournalJournal of the American College of Nutrition
Issue number8
StatePublished - Nov 17 2019


  • CDSS
  • celiac
  • tissue transglutaminase

ASJC Scopus subject areas

  • Medicine (miscellaneous)
  • Nutrition and Dietetics


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