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FOCUS: Future of fecal calprotectin utility study in inflammatory bowel disease

View Article: PubMed Central - PubMed

ABSTRACT

Aim: To evaluate the perspective of gastroenterologists regarding the impact of fecal calprotectin (FC) on the management of patients with inflammatory bowel disease (IBD).

Methods: Patients with known IBD or symptoms suggestive of IBD for whom the physician identified that FC would be clinically useful were recruited. Physicians completed an online “pre survey” outlining their rationale for the test. After receipt of the test results, the physicians completed an online “post survey” to portray their perceived impact of the test result on patient management. Clinical outcomes for a subset of patients with follow-up data available beyond the completion of the “post survey” were collected and analyzed.

Results: Of 373 test kits distributed, 290 were returned, resulting in 279 fully completed surveys. One hundred and ninety patients were known to have IBD; 147 (77%) with Crohn’s Disease, 43 (21%) Ulcerative Colitis and 5 (2%) IBD unclassified. Indications for FC testing included: 90 (32.2%) to differentiate a new diagnosis of IBD from Irritable Bowel Syndrome (IBS), 85 (30.5%) to distinguish symptoms of IBS from IBD in those known to have IBD and 104 (37.2%) as an objective measure of inflammation. FC levels resulted in a change in management 51.3% (143/279) of the time which included a significant reduction in the number of colonoscopies (118) performed (P < 0.001). Overall, 97.5% (272/279) of the time, the physicians found the test sufficiently useful that they would order it again in similar situations. Follow-up data was available for 172 patients with further support for the clinical utility of FC provided.

Conclusion: The FC test effected a change in management 51.3% of the time and receipt of the result was associated with a reduction in the number of colonoscopies performed.

No MeSH data available.


Impact of positive or negative fecal calprotectin result on colonoscopy occurrence. Reduction in colonoscopies planned as a result of the availability of the fecal calprotectin test. There was a significant reduction in colonoscopies planned (P < 0.001). FC: Fecal calprotectin.
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Figure 3: Impact of positive or negative fecal calprotectin result on colonoscopy occurrence. Reduction in colonoscopies planned as a result of the availability of the fecal calprotectin test. There was a significant reduction in colonoscopies planned (P < 0.001). FC: Fecal calprotectin.

Mentions: For 142 patients, the physician reported that if the FC test was not available, they would have performed a colonoscopy. After receipt of the FC result, a colonoscopy was planned according to the post-survey responses for 20 patients resulting in 122 colonoscopies (86%) that were not performed in favour of performing a FC test. Conversely, for 137 patients, a colonoscopy was not planned, however, after receipt of the FC result, 4 patients underwent a colonoscopy as per the post-survey responses. Combining these two groups, there was a significant reduction in the total number of colonoscopies performed (118) due to the availability of the FC test (P < 0.001) (Figure 3).


FOCUS: Future of fecal calprotectin utility study in inflammatory bowel disease
Impact of positive or negative fecal calprotectin result on colonoscopy occurrence. Reduction in colonoscopies planned as a result of the availability of the fecal calprotectin test. There was a significant reduction in colonoscopies planned (P < 0.001). FC: Fecal calprotectin.
© Copyright Policy - open-access
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC5037090&req=5

Figure 3: Impact of positive or negative fecal calprotectin result on colonoscopy occurrence. Reduction in colonoscopies planned as a result of the availability of the fecal calprotectin test. There was a significant reduction in colonoscopies planned (P < 0.001). FC: Fecal calprotectin.
Mentions: For 142 patients, the physician reported that if the FC test was not available, they would have performed a colonoscopy. After receipt of the FC result, a colonoscopy was planned according to the post-survey responses for 20 patients resulting in 122 colonoscopies (86%) that were not performed in favour of performing a FC test. Conversely, for 137 patients, a colonoscopy was not planned, however, after receipt of the FC result, 4 patients underwent a colonoscopy as per the post-survey responses. Combining these two groups, there was a significant reduction in the total number of colonoscopies performed (118) due to the availability of the FC test (P < 0.001) (Figure 3).

View Article: PubMed Central - PubMed

ABSTRACT

Aim: To evaluate the perspective of gastroenterologists regarding the impact of fecal calprotectin (FC) on the management of patients with inflammatory bowel disease (IBD).

Methods: Patients with known IBD or symptoms suggestive of IBD for whom the physician identified that FC would be clinically useful were recruited. Physicians completed an online &ldquo;pre survey&rdquo; outlining their rationale for the test. After receipt of the test results, the physicians completed an online &ldquo;post survey&rdquo; to portray their perceived impact of the test result on patient management. Clinical outcomes for a subset of patients with follow-up data available beyond the completion of the &ldquo;post survey&rdquo; were collected and analyzed.

Results: Of 373 test kits distributed, 290 were returned, resulting in 279 fully completed surveys. One hundred and ninety patients were known to have IBD; 147 (77%) with Crohn&rsquo;s Disease, 43 (21%) Ulcerative Colitis and 5 (2%) IBD unclassified. Indications for FC testing included: 90 (32.2%) to differentiate a new diagnosis of IBD from Irritable Bowel Syndrome (IBS), 85 (30.5%) to distinguish symptoms of IBS from IBD in those known to have IBD and 104 (37.2%) as an objective measure of inflammation. FC levels resulted in a change in management 51.3% (143/279) of the time which included a significant reduction in the number of colonoscopies (118) performed (P &lt; 0.001). Overall, 97.5% (272/279) of the time, the physicians found the test sufficiently useful that they would order it again in similar situations. Follow-up data was available for 172 patients with further support for the clinical utility of FC provided.

Conclusion: The FC test effected a change in management 51.3% of the time and receipt of the result was associated with a reduction in the number of colonoscopies performed.

No MeSH data available.