A study of search engine queries shows people at risk for celiac are hard to identify based on symptoms. The analysis from Columbia University tried to identify what inquiries users made prior to being diagnosed with celiac but found no common set of terms.
The cost of screening everyone for celiac would be high, but so is the burden of undiagnosed disease. This study explores an alternative to screening: case finding, which identifies and screens only groups most at risk. While experts advise testing everyone with a family history of celiac, finding patients outside this group requires other information, such as symptoms. This study confirms that undiagnosed patients experience such variable symptoms that they are hard to distinguish from the general population.
The study extracted all queries submitted to Bing in the United States from January to October 2017. It identified 90,142 users who submitted a new celiac-related inquiry in October without any in the previous nine months. This narrowed to 6,528 who showed sustained interest by querying celiac more than once, likely indicating a new diagnosis. The study then analyzed all symptom inquiries prior to the supposed diagnosis.
This approach helped include symptoms patients might feel embarrassed to discuss. The data showed an increase in queries about celiac symptoms such as diarrhea, bloating and weight loss prior to the date of diagnosis. Searches about depression and anxiety also increased.
