Olivia Green

Looking into patients with Coeliac Disease and identifying those at low risk of fracture with the FRAX tool to save healthcare costs and unnecessary patient investigations.

Medical Student Prize Winner

“The Clinical Utility of the FRAX Tool in Coeliac Disease: the Largest Biopsy-Proven Cohort Study.”

Ms Green wanted to look into gastroenterological symptoms and how they have an impact on people’s lives and self-esteem. She understood that if not well controlled, symptoms can have a significant impact on lives and as a whole, poorly managed gastrointestinal conditions often have consequences for other systems within our bodies outside of the gut.

Ms Green explains:

Coeliac disease (CD) is a common autoimmune gluten-mediated enteropathy, affecting approximately 1% of the population. Reduced bone density (osteoporosis) is an established complication of CD. There is currently conflicting guidance on how to manage the bone health of patients with CD, particularly regarding when measuring bone density through dual X-ray absorptiometry (DXA) scanning is required.

Our project had three key aims:

  • to assess the prevalence of osteoporosis in a cohort of patients with CD
  • to determine which factors influence reduced bone density in CD
  • to determine if there is any role for the FRAX fracture risk assessment tool in the management of patients with CD

We found that around 1 in 6 of patients in our cohort had osteoporosis.

Additionally, we found that patients with less severe histological grading at diagnosis had a higher average bone density than those with more severe histology at diagnosis. Patients with ongoing gluten exposure had a higher incidence of fractures than those without.

We concluded that the FRAX tool has a role in identifying those at low risk of fracture, thus avoiding superfluous DXA scans. As each DXA scan costs approximately £70, this tool could potentially lead to a significant reduction in healthcare costs and avoid subjecting individuals to unnecessary investigations.

Why did you choose this project?

Olivia (third from left) with (from left to right) Prof Andy Veitch, BSG President 2022-2024, Veena Shivakumar, Radika Shah, Advait Upadhyaya and Dr Riadh Jazrawi of Dr Falk.

“A key motivation for me to undertake a research project was that I wanted to experience and understand the scope of medicine, beyond both clinical work and what is taught in the medical school curriculum. I was also very keen to develop key skills such as critical analysis.”

I feel honoured to have received this award, as it is a recognition of the last several months of work leading up the completion of this project. This award has helped me understand that medical students can produce important research and has made a career in research seem more accessible to me, even though I haven’t yet completed medical school. This recognition has increased my desire to produce further work in the future alongside a clinical career.

- Olivia Green

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