In terms of test accuracy in testing for coeliac disease, IgA EMA (using indirect immunofluorescence) is the most accurate test. If an ELISA test was required, which may be more suitable for screening purposes as it can be semi-automated, testing for IgA TTG is likely to be most accurate. The decision-analytic model shows that the most accurate tests combined with confirmatory biopsy are the most cost-effective, whilst combinations of tests add little or no further value. There is limited information regarding test accuracy in populations with diabetes, and there is some uncertainty over whether the test characteristics would remain the same, particularly as there may be a proportion of silent disease. Further research is required regarding the role of screening in silent coeliac disease and regarding long-term outcomes and complications of untreated coeliac disease.