Use of fecal occult blood testing in hospitalized patients: Results of an audit |
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Authors: | Stephen Ip AbdulRazaq AH Sokoro Lisa Kaita Claudia Ruiz Elaine McIntyre Harminder Singh |
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Affiliation: | 1.Department of Medicine, University of Manitoba;;2.Department of Pathology, University of Manitoba;;3.Diagnostic Services of Manitoba;;4.Winnipeg Regional Health Authority;;5.Department of Community Health Sciences, University of Manitoba;;6.Department of Hematology and Oncology, CancerCare Manitoba;;7.University of Manitoba IBD Clinical and Research Centre, Winnipeg, Manitoba |
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Abstract: | BACKGROUND:The fecal occult blood test (FOBT), widely used as a colorectal cancer screening tool, continues to be used in hospitalized patients. However, the utility of this test for hospitalized patients is unclear.OBJECTIVE:To assess FOBT use in a large urban regional health authority.METHODS:Reports of all FOBTs performed between April 1, 2011 and March 30, 2012 from two academic and four community hospitals in Winnipeg (Manitoba) were extracted. Of 650 hospitalizations with a positive FOBT result and 1254 with a negative FOBT result, random samples of 230 and 97 charts, respectively, were reviewed. Information including demographics, admission diagnos(es), indication(s) for ordering the FOBT and clinical management was extracted.RESULTS:Thirty-four percent (650 of 1904) of hospitalizations with an FOBT had a positive FOBT result. Family medicine physicians ordered approximately one-half of the reviewed FOBTs. The most common indication for ordering an FOBT was anemia. Of those with a positive FOBT, 66% did not undergo further gastrointestinal investigations. Of those with a positive FOBT and overt gastrointestinal bleeding and/or melena who underwent endoscopy, 60% had their endoscopy performed before the FOBT result being reported while 38% underwent their endoscopy ≥3 days after the stool sample was collected. There were minimal differences in clinical practices between academic and community hospitals.CONCLUSIONS:The present study suggests that FOBT results in hospitalized patients may have little beneficial impact on clinical management. Hospital laboratories may be better served in directing resources to other tests. |
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Keywords: | Inpatients Occult blood Utilization |
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