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No difference in emergency department visits before and after transition for coeliac disease
  1. Norelle R Reilly1,2,
  2. Peter H R Green1,
  3. Jonas F Ludvigsson3,4
  1. 1Celiac Disease Center, Department of Medicine, Columbia University College of Physicians and Surgeons, New York, New York, USA
  2. 2Division of Pediatric Gastroenterology, Department of Pediatrics, Columbia University Medical Center, New York, New York, USA
  3. 3Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, Stockholm, Sweden
  4. 4Department of Pediatrics, Örebro University Hospital, Örebro, Sweden
  1. Correspondence to Dr Jonas F Ludvigsson, Department of Medical Epidemiology and Biostatistics, Karolinska Institutet, 17177 Stockholm, Sweden; jonasludvigsson{at}

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In a recent consensus document, we and others presented recommendations for the transition of care from childhood to adulthood in coeliac disease (CD).1 Models of care transition share a goal of prevention of medical care lapses. Lower continuity of general paediatric care has been associated with greater risk of emergency department (ED) visits and hospitalisation.2 Yet patient vulnerability during and immediately following transition may be under-recognised. Poorer medical adherence has been noted for young adults with chronic illnesses during their transition to adult care.3 ,4 In a US study, ED visits comprised over 20% of the medical care of young adults, a significantly greater proportion than in other age groups.5 Young adults with sickle cell disease in the midst of transition to adult care had more ED visits when compared with those with stable paediatric care or who were able to successfully establish adult care.6

To assess the transition burden on young …

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  • Contributors NRR and JFL conceived and designed the study with input from PHRG. JFL collected the data, performed the statistics and funded the study. All authors interpreted the data and contributed to the writing of the paper. All authors revised and approved the final version.

  • Funding All authors have completed the ICMJE uniform disclosure form at and declare that this project was supported by grants from the Swedish Society of Medicine and the Swedish Research Council.

  • Competing interests None declared.

  • Ethics approval This project (2008/1182-31/4) was approved by the Research Ethics Committee of the Karolinska Institute, Sweden on 3 September 2008.

  • Provenance and peer review Not commissioned; internally peer reviewed.

  • Data sharing statement Other researchers can apply for our data through the Swedish National Board of Health and Welfare.

  • Transparency The lead author affirms that this manuscript is an honest, accurate and transparent account of the study being reported; that no important aspects of the study have been omitted; and that any discrepancies from the study as planned (and, if relevant, registered) have been explained.

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