Procedure volume influences adherence to celiac disease guidelines.

Background: Although the prevalence of celiac disease in the USA approaches 1%, most cases are undiagnosed, in part, because of low adherence to the recommendation of submitting at least four specimens during duodenal biopsy. We aimed to determine whether physician and practice characteristics are associated with adherence to this recommendation.

Materials And Methods: We used a large national pathology database to identify all adult patients who underwent duodenal biopsy during 2006-2009.