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Chemist coeliac test is a false positive

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Doctors have warned lives could be put at risk by a test for coeliac disease being heavily promoted by two nationwide chemist shop chains.

Amcal and Guardian branded chemists are offering a $45 blood test they claim is 93 per cent accurate in diagnosing the serious illness, which affects up to 2 per cent of Australians.

But AMA New South Wales President Dr Saxon Smith, said he was alarmed by the move, which he warned would fragment care and may give rise to missed or false diagnoses that could put lives at risk.

Writing in the Sydney Morning Herald, Dr Smith said the test being offered by the chemist chains had serious limitations.

He said research by the company that made the test showed that, while it was quite effective at identifying those who did not have coeliac disease, “it falls down significantly when it comes to those who do”.

“It is only 49 per cent accurate when it comes to positive results, which means more than half the people the test says have coeliac disease actually don’t,” Dr Smith said.

He said this was particularly a concern because of evidence that people without coeliac disease who followed a gluten-free diet suffered poorer health.

Dr Smith said the screening questions presented before taking the test were “exceptionally vague”, and some of the symptoms described could actually indicate other serious conditions such as stomach cancer, inflammatory bowel disease or a thyroid condition.

He said diagnosing coeliac disease was not a simple task and it was inappropriate that it be done “between the toothpaste and the toilet paper in a chemist”.

“Diagnosis is not straight forward, as there needs to be a level of clinical suspicion about the diseases,” Dr Smith said, adding that unexplained iron deficiency or osteoporosis could be indicators.’

“There are questions about your health and your family’s health that need to be asked to evaluate your risk,” he said. “There are blood samples tests as, ultimately, a biopsy of the bowel via endoscopy for a definitive diagnosis.”

He said coeliac disease was an important medical condition that could lead to serious complications such as lymphoma and osteoporosis, and its detection and on-going management required the skills of a doctor, not a pharmacist.

“Doctors’ highest duty of care is to look after you and your loved ones,” he said. “This is what the law demands. I wonder if the pharmacists who choose to sell this test truly understand this expectation and what it entails.”

Adrian Rollins