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Children with celiac disease report 7% higher health-related quality of life than their parentsChildren with Celiac Disease Report Better Quality of Life

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Key Takeaway
Note that children with celiac disease report higher HRQoL than parents, suggesting a discrepancy in perceived burden.

This meta-analysis evaluates health-related quality of life (HRQoL) in children and adolescents with celiac disease, comparing child self-reports to parent-proxy assessments using the CeD Dutch Questionnaire (CDDUX). The analysis included data from 2,453 children and 2,257 parents across 14 countries.

Findings indicate that children reported a 7% higher HRQoL than their parents. Within specific domains, the 'Having CD' domain was identified as the dimension most affected by the disease, while the 'Communication' domain showed the highest scores, suggesting it was relatively preserved. Differences were also noted in the 'Diet' domain between child and parent reports.

Limitations include uncertainty regarding the clinical significance of the pooled difference. Additionally, geographic variations in HRQoL should be interpreted with caution as comparability across different language versions and cultural settings was not established. Clinicians should note that parent and child perceptions of disease burden frequently differ, and generic HRQoL tools may underestimate the psychosocial burden of celiac disease.

How this fits prior evidence

This meta-analysis addresses a gap in understanding the discrepancy between patient and caregiver perceptions of disease burden. While previous evidence notes that structured monitoring may improve intestinal mucosa histology in Celiac Disease patients and that neuropsychiatric manifestations require multidisciplinary management, this study specifically highlights that children report a 7% higher HRQoL than parents. This suggests that parental proxy reports may not fully capture the child's lived experience of the disease.

Researchers looked at how children and adolescents with celiac disease feel about their daily lives. They compared the self-reports of 2,453 children against the observations of 2,257 parents across 14 different countries. The study focused on health-related quality of life, which includes how a condition affects a person's daily well-being.

The results showed that children reported a higher quality of life than their parents reported. While both groups felt the impact of having celiac disease, the children's scores were 7% higher. The study also found that the most affected area for both groups was the actual experience of having the disease, while communication remained the best-preserved area.

Because parents and children often see the burden of a condition differently, these findings suggest that standard tools might not capture the full picture of a child's experience. However, because the study was a meta-analysis of different regions, the results should be viewed with caution. It is important to talk to a doctor to understand how these differences might affect a child's specific care plan.

What this means for you:
Children with celiac disease often report a better quality of life than their parents do, showing different perspectives.

Common questions

How do children and parents differ in their views on celiac disease?

Children with celiac disease reported a 7% higher quality of life than their parents reported. While both groups identified the fact of having the disease as the most affected area, the children's self-reports were generally more positive than the proxy reports provided by their parents.

What specific areas of life were most and least affected?

The study found that the domain of having celiac disease had the lowest scores, meaning it was the most affected dimension for both children and parents. In contrast, the communication domain had the highest scores, suggesting it was the area most preserved for those living with the condition.

Why is it important to know that parents and children see things differently?

Because parents and children often have different perceptions of the burden of a disease, standard questionnaires might not capture the full psychosocial impact. This highlights the importance of listening to a child's own perspective when managing their health and daily life.

Study Details

Study typeMeta analysis
EvidenceLevel 1
PublishedOct 2026
View Original Abstract ↓
UNLABELLED: To evaluate differences in health-related quality of life (HRQoL) between child self-reports and parent-proxy assessments in children and adolescents with celiac disease (CeD) using the CeD Dutch Questionnaire (CDDUX), and to describe disease-specific HRQoL patterns across the included populations. A systematic review and meta-analysis was conducted according to PRISMA guidelines. Studies assessing HRQoL in pediatric CeD using the CDDUX questionnaire were identified through PubMed, Scopus, Google Scholar, and Cochrane Library databases. Pooled analyses were performed using random-effects models and expressed as ratios of means (RoM). Twenty-one studies from 14 countries, including 2,453 children with CeD and 2,257 parents, were included. Children consistently reported better HRQoL than perceived by their parents, with self-reported scores 7% higher overall. Differences were observed across all domains, particularly for "Diet". Overall, CDDUX scores indicated neutral HRQoL. Across studies, domain scores followed a consistent hierarchical pattern, with "Having CD" showing the lowest scores and "Communication" the highest. Marked geographic differences emerged, with the highest HRQoL scores reported in South America and the lowest in the Middle East and North Africa. CONCLUSION: Children with CeD reported higher HRQoL than their parents perceived, although the clinical importance of the pooled difference remains uncertain. The emotional burden of living with CeD represents the most affected dimension of HRQoL, while communication-related aspects are relatively preserved. Geographic variation emerged, however should be interpreted cautiously because comparability across language versions and cultural settings was not established. WHAT IS KNOWN: • Generic health-related quality of life questionnaires may underestimate the psychosocial burden associated with celiac disease; parent and child perceptions of disease burden frequently differ. WHAT IS NEW: • Parents consistently report lower health-related quality of life scores than children themselves, particularly in the "Diet" domain, while the"Having celiac disease" domain represents the greatest psychosocial burden worldwide.
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