Diagnostic Accuracy of Point-of-Care Fecal Calprotectin and Immunochemical Occult Blood Tests for Diagnosis of Organic Bowel Disease in Primary Care: The Cost-Effectiveness of a Decision Rule for Abdominal Complaints in Primary Care (CEDAR) Study

Abstract

BACKGROUND:Fecal biomarker tests that differentiate between organic bowel disease (OBD) and non-OBD in primary care patients with persistent lowerabdomen complaints could reduce the number of unnecessary referrals for endoscopy. We quantified the accuracy of fecal calprotectin and immunochemical occult blood (iFOBT) point-of-care (POC) tests and a calprotectin ELISA in primary care patients with suspected OBD.

Fecal calprotectin concentration in the differential diagnosis of bowel diseases

“…При тщатель-ном обследовании у больного диагностирована БК тонкой кишки с сегментарным вовлечением подвздошной, тощей кишок, воспалительно-инфильтративная форма в сочета-нии с целиакией. Такая клиническая ситуация подтверж-дает целесообразность использования ФКП в качестве скрининг-теста на наличие ВЗК с локализацией не только в толстой кишке, но и в тонкой [12,13].…”

Faecal calprotectin testing for differentiating amongst inflammatory and non-inflammatory bowel diseases: systematic review and economic evaluation

“…38 In various studies, the proportion of patients referred for further investigation, in whom abnormal findings are reported on colonoscopy, is low. Kok et al 39 noted reports that only 22-37% had organic bowel disease (OBD).…”

Faecal calprotectin in patients with suspected colorectal cancer: a diagnostic accuracy study

“…[20][21][22] Fewer than 50% of patients evaluated by Mowat et al were urgent referrals and the number with suspected cancer is not specified. 21 Two papers looked largely at IBD as the non-neoplastic organic enteric disease of interest but, in the present study, IBD represents only 25% of all organic enteric disease.…”

“…21 Two papers looked largely at IBD as the non-neoplastic organic enteric disease of interest but, in the present study, IBD represents only 25% of all organic enteric disease. 20,22 Faecal immunochemical occult blood testing (FIT) is an important alternative screening technology. This too has a high NPV and the advantage of NICE guidance NG12 to support its use.…”

“…Others have found a similar NPV when comparing FC and FIT. 20,22 Currently, FIT is not a widely-available test for the symptomatic population in primary and secondary care.…”