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Fig 1.

PRISMA flow diagram.

Abbreviations: BSG: Guidelines from the British Society of Gastroenterology [9]; NICE: National Institute for Health and Care Excellence; ESsCD: European Society for the Study of Coeliac Disease guideline [8]; ESPGHAN: European Society Paediatric Gastroenterology, Hepatology and Nutrition Guidelines [7].

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Fig 1 Expand

Table 1.

Summary table of study characteristics.

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Table 1 Expand

Fig 2.

Summary graph of risk of bias.

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Fig 2 Expand

Fig 3.

Sensitivity, specificity, and positive predictive values.

Meta-analysis results are shown per diagnostic indicator. Positive predictive values (PPVs) were calculated for a population with a CD prevalence of 1% (red dotted line) using the estimated sensitivities and specificities from the meta-analyses. Diagnostic indicators are ordered from high to low PPV per diagnostic indicator group. The area of the box size is proportional to the total number of participants.

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Fig 3 Expand

Fig 4.

Subgroup analysis stratified by age group and CD diagnosis.

Stratified meta-analysis results are shown per diagnostic indicator. Positive predictive values (PPVs) were calculated for a population with a CD prevalence of 1% (red dotted line) using the estimated sensitivities and specificities from the meta-analyses. The area of the box size is proportional to the total number of participants.

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Fig 4 Expand

Fig 5.

Sensitivity analysis restricting to cohort studies.

Sensitivity meta-analysis on study design. Positive predictive values (PPVs) were calculated for a population with a CD prevalence of 1% (red dotted line) using the estimated sensitivities and specificities from the meta-analyses. The area of the box size is proportional to the total number of participants.

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Fig 5 Expand