I have to start with a long story but I will eventually get to the point so please bear with me.
In 2010 I was tested for celiac disease. The tests run were TT IgA, Gliadin IgA, Gliadin IgG, Reticulin IgA Autoabs, and Endomysial IgA Autoabs. The *only* test that came back positive in that group was the Gliadin IgA. Given that the test was run in 2010, I am certain it was the AGA version. That version of the test is no longer performed. I found this footnote at the bottom of a labtestsonline page:
"Historically, a test for anti-gliadin antibody (AGA) was used in the evaluation of celiac disease. The 2013 American College of Gastroenterology guidelines recommend against this test for the primary detection of celiac disease due to concerns with its accuracy. It is inferior to the tests for anti-tTG and anti-DPG and should no longer be part of routine testing for celiac disease. The American Gastroenterology Association makes similar recommendations."
The phrase 'concerns with its accuracy' does nothing to tell me whether the test skewed more toward false positives or false negatives so I looked a little bit more and found this article which actually lists percentages:
According to this article, the AGA IgA test had a 72% accuracy rate.
Do you realize that the Intrinsic Factor antibody test, which is the only test that can specifically diagnose Pernicious Anemia, has only a 60% accuracy rate?
I can't help but be irate that the medical establishment has seen fit to discontinue (and actually replace) the AGA Iga test, but is still completely reliant upon the IF antibody test which misses *almost half* of the people who have PA.
What does it take to get a better test developed and put into practice? Is there something to be learned from the process that resulted in replacing the AGA test?
As frustrating as it is to know that a terribly inaccurate test is all that is currently available, at least it is apparent that tests can sometimes be improved upon and replaced. I hope we can get a more accurate Pernicious Anemia test widely available someday.