CD: Prebiotics/Probiotics (2021)
Author and Year:
                            
                                Harnett J, Myers S, Rolfe M 2016 
                            
                        
                
                            PubMed ID:
                            
                        
                
                            Article Title:
                            
                                Probiotics and the Microbiome in Celiac Disease: A Randomised Controlled Trial. 
                            
                        
                
                            Authors:
                            
                                Harnett J, Myers S, Rolfe M 
                            
                        
                
                            Journal:
                            
                                Evidence-based Complementary and Alternative medicine 
                            
                        
                
                            Year of publication:
                            
                                2016 
                            
                        
                
                            Volume:
                            
                                2016 
                            
                        
                
                            Issue:
                            Page numbers:
                            
                                9048574 
                            
                        
                
                            Study Design:
                            
                                Randomized Controlled Trial 
                            
                        
                
                            Risk of Bias Assessment Rating:
                             Positive
 
                                    Positive 
                            Inclusion Criteria:
                            
                                Being between 18 and 70 years of age; CoeD confirmed by small bowel biopsy more than twelve months before enrolling in the study; being currently on a GFD and for at least twelve months.
 
                            
                        
                
                            Exclusion Criteria:
                            
                                Pregnant; less than 18 years of age; diagnosed with CoeD in the preceding 12 months; consuming a diet containing gluten; diagnosed with major gastrointestinal pathology (e.g., Crohn’s disease or ulcerative colitis); had short bowel syndrome; had recent oral or bowel surgery; had cancer, were HIV-positive, were active alcoholic, and/or had illicit drug dependence.; use nonsteroidal anti-inflammatory drugs, steroids, or antibiotics in the four weeks before the start of the trial; clinical abnormalities in serum urea, electrolytes, creatinine, or liver function values; unwilling to comply with the study protocol or in the opinion of the investigators could compromise the study. 
                            
                        
                
                            Research Purpose:
                            
                                To examine the effects of a probiotic supplement on the celiac disease microbiota 
                            
                        
                
                            Blinding efforts:
                            
                                The researchers, the participants, and the statistician were blinded to treatment allocation. 
                            
                        
                
                            Study Location:
                            
                                Australia 
                            
                        
                
                            Source(s) of Funding:
                            
                                Industry,  Other,  Scholarship,  but exact funding source of the scholarship not reported.  
                            
                        
                
                            Please specify names of funders:
                            
                                Diagnostic Insight Pty. Ltd. (provision of test kits, biological specimen transportation and provision of the Sydney clinical trial site); Metametrix Laboratory (provision of laboratory analysis and consulting services); and Orphan-Sigma Pty. Ltd. (the provision of the study medication and financing the blood safetymonitoring). Author was the recipient of an Australian Postgraduate Award Scholarship. 
                            
                        
| Quality Criteria Checklist: Primary Research | |||
| Relevance Questions | |||
| 1. | Would implementing the studied intervention or procedure (if found successful) result in improved outcomes for the patients/clients/population group? (Not Applicable for some epidemiological studies) | Yes | |
| 2. | Did the authors study an outcome (dependent variable) or topic that the patients/clients/population group would care about? | Yes | |
| 3. | Is the focus of the intervention or procedure (independent variable) or topic of study a common issue of concern to dieteticspractice? | Yes | |
| 4. | Is the intervention or procedure feasible? (NA for some epidemiological studies) | Yes | |
| Validity Questions | |||
| 1. | Was the research question clearly stated? | Yes | |
| 1.1. | Was (were) the specific intervention(s) or procedure(s) [independent variable(s)] identified? | Yes | |
| 1.2. | Was (were) the outcome(s) [dependent variable(s)] clearly indicated? | Yes | |
| 1.3. | Were the target population and setting specified? | Yes | |
| 2. | Was the selection of study subjects/patients free from bias? | Yes | |
| 2.1. | Were inclusion/exclusion criteria specified (e.g., risk, point in disease progression, diagnostic or prognosis criteria), and with sufficient detail and without omitting criteria critical to the study? | Yes | |
| 2.2. | Were criteria applied equally to all study groups? | Yes | |
| 2.3. | Were health, demographics, and other characteristics of subjects described? | Yes | |
| 2.4. | Were the subjects/patients a representative sample of the relevant population? | Yes | |
| 3. | Were study groups comparable? | Yes | |
| 3.1. | Was the method of assigning subjects/patients to groups described and unbiased? (Method of randomization identified if RCT) | Yes | |
| 3.2. | Were distribution of disease status, prognostic factors, and other factors (e.g., demographics) similar across study groups at baseline? | Yes | |
| 3.3. | Were concurrent controls or comparisons used? (Concurrent preferred over historical control or comparison groups.) | Yes | |
| 4. | Was method of handling withdrawals described? | Yes | |
| 4.1. | Were follow-up methods described and the same for all groups? | Yes | |
| 4.2. | Was the number, characteristics of withdrawals (i.e., dropouts, lost to follow up, attrition rate) and/or response rate (cross-sectional studies) described for each group? (Follow up goal for a strong study is 80%.) | Yes | |
| 4.3. | Were all enrolled subjects/patients (in the original sample) accounted for? | Yes | |
| 4.4. | Were reasons for withdrawals similar across groups? | Yes | |
| 5. | Was blinding used to prevent introduction of bias? | Yes | |
| 5.1. | In intervention study, were subjects, clinicians/practitioners, and investigators blinded to treatment group, as appropriate? | Yes | |
| 5.2. | Were data collectors blinded for outcomes assessment? (If outcome is measured using an objective test, such as a lab value, this criterion is assumed to be met.) | Yes | |
| 6. | Were intervention/therapeutic regimens/exposure factor or procedure and any comparison(s) described in detail? Were interveningfactors described? | Yes | |
| 6.1. | In RCT or other intervention trial, were protocols described for all regimens studied? | Yes | |
| 6.3. | Was the intensity and duration of the intervention or exposure factor sufficient to produce a meaningful effect? | Yes | |
| 6.4. | Was the amount of exposure and, if relevant, subject/patient compliance measured? | Yes | |
| 6.5. | Were co-interventions (e.g., ancillary treatments, other therapies) described? | No | |
| 6.6. | Were extra or unplanned treatments described? | No | |
| 6.7. | Was the information for 6.4, 6.5, and 6.6 assessed the same way for all groups? | Yes | |
| 7. | Were outcomes clearly defined and the measurements valid and reliable? | Yes | |
| 7.1. | Were primary and secondary endpoints described and relevant to the question? | Yes | |
| 7.2. | Were nutrition measures appropriate to question and outcomes of concern? | Yes | |
| 7.3. | Was the period of follow-up long enough for important outcome(s) to occur? | Yes | |
| 7.4. | Were the observations and measurements based on standard, valid, and reliable data collection instruments/tests/procedures? | Yes | |
| 7.5. | Was the measurement of effect at an appropriate level of precision? | Yes | |
| 7.6. | Were other factors accounted for (measured) that could affect outcomes? | Yes | |
| 7.7. | Were the measurements conducted consistently across groups? | Yes | |
| 8. | Was the statistical analysis appropriate for the study design and type of outcome indicators? | Yes | |
| 8.1. | Were statistical analyses adequately described and the results reported appropriately? | Yes | |
| 8.2. | Were correct statistical tests used and assumptions of test not violated? | Yes | |
| 8.3. | Were statistics reported with levels of significance and/or confidence intervals? | Yes | |
| 8.4. | Was "intent to treat" analysis of outcomes done (and as appropriate, was there an analysis of outcomes for those maximally exposed or a dose-response analysis)? | Yes | |
| 8.5. | Were adequate adjustments made for effects of confounding factors that might have affected the outcomes (e.g., multivariate analyses)? | Yes | |
| 8.6. | Was clinical significance as well as statistical significance reported? | Yes | |
| 8.7. | If negative findings, was a power calculation reported to address type 2 error? | Yes | |
| 9. | Are conclusions supported by results with biases and limitations taken into consideration? | Yes | |
| 9.1. | Is there a discussion of findings? | Yes | |
| 9.2. | Are biases and study limitations identified and discussed? | Yes | |
| 10. | Is bias due to study's funding or sponsorship unlikely? | Yes | |
| 10.1. | Were sources of funding and investigators' affiliations described? | Yes | |
| 10.2. | Was the study free from apparent conflict of interest? | Yes | |


