ASCP and PLUGS Design Education to Enhance Diagnostic Testing of Celiac Disease

Celiac disease is often underdiagnosed because patients exhibit minimal symptoms or are misdiagnosed because of confusion with other conditions.  

A chronic digestive and immune disorder that damages the small intestine, it is also one of the few autoimmune conditions that can be detected with a single laboratory test that is more than 95 percent sensitive and specific, according to Jane Dickerson, PhD, clinical associate professor in the Department of Laboratory Medicine and Pathology at the University of Washington as well as Division Head of Laboratory Medicine, director of the Core Lab Reference Laboratory Services, and medical director of the North Clinic Laboratory at Seattle Children’s Hospital. She is also co-founder of the Patient-Centered Laboratory Utilization Guidance Services (PLUGS). 

Celiac disease affects the abdomen and may cause a feeling of bloating or nausea, and unexplained weight loss. It is caused by a diet that includes gluten, which is found in bread or pasta. Currently, there are many antibody tests available to diagnose the disease.    

ASCP is collaborating with experts from the PLUGS network to develop an education module that highlights when and which laboratory tests are best used in the diagnosis and management of celiac disease. The education offers a case-based activity designed to help medical laboratory professionals, laboratory directors, and pathologists to improve their knowledge, skills, and competence in recognizing which diagnostic tests are most appropriate to use in the diagnosis of celiac disease and to focus on evidence-based guidelines.   

“The testing algorithm for the diagnosis of celiac disease is very complex, and there are many providers who don’t know the appropriate testing strategy,” explains Sachin Gupta, PhD, MBA, MT(ASCPi)MB, Lean SSBB, scientific director of ASCP’s Center for Quality and Patient Safety.  

Dr. Dickerson specializes in celiac disease and has published several research articles on the topic. Along with colleagues Maria Christina Pacheco, MD, and Rebecca Wilson, PhD, she is a primary author of the education developed in collaboration with ASCP. Dr. Gupta and Elise Occhipinti, MD, FASCP, reviewed and contributed to the education. Dr. Occhipinti, chair of ASCP’s Quality and Patient Safety Steering Committee and an advising member in PLUGS, was the catalyst for the collaboration.   

The goal of the new education is to educate laboratory professionals and pathologists on testing algorithms to select the right test. “We explain if a patient comes with certain symptoms, what testing should be ordered by provider,” Dr. Gupta says.   

In the education module, participants are asked a series of questions, each followed by a choice of responses. The user would select a specific answer and then receive an explanation of why their answer is correct or incorrect. If it is incorrect, the program asks the user to revisit information on that particular topic in order to enhance their knowledge.  

This is the first education product with PLUGS.  

“We are very excited about our collaboration with ASCP,” Dr. Dickerson says. “The collaboration represents a strategic alignment between two organizations deeply committed to improving the quality and value of laboratory medicine. PLUGS brings expertise in laboratory stewardship, utilization management, and navigating the complexities of insurance reimbursement, with a strong emphasis on reducing inappropriate testing and financial toxicity for patients. ASCP, as a leading professional organization for pathologists and laboratory professionals, contributes its vast network, influence in clinical practice guidelines, and commitment to advancing diagnostic excellence and professional development. Together, they create a powerful platform for systemic improvement in laboratory test ordering, interpretation, and coverage.”  

PLUGS is based at Seattle Children’s Hospital and is a consortium whose members are able to access its test utilization consultation services.   

“Many laboratories lack this kind of education,” says Dr. Gupta. “I hope laboratories and pathologists will leverage this education and implement the evidence-based testing algorithm at their labs.”