An audit of the utility of in-patient fecal occult blood testing

The American Journal of Gastroenterology
V K SharmaC W Howden

Abstract

Recent surveys of physician practice have suggested the existence of excessive, inappropriate use of the fecal occult blood test (FOBT). We studied the implementation of this test in hospitalized patients. We performed a retrospective chart review of 1000 randomly selected patients who had been discharged from the Medicine service at four teaching hospitals. Patient demographics, clinical presentation, presence or absence of overt GI bleeding, and use of medications that might affect the FOBT were recorded. Reviewers assessed whether patients who had FOBT would have been candidates for colon resection if asymptomatic colon cancer had been found. Digital rectal examination was documented in 44.8% of patients; the findings were recorded in only 9%. A total of 421 patients had FOBT on admission, usually on stool obtained at digital rectal examination. Of the patients with a positive FOBT, 17% had active GI bleeding. Only 41.1% of patients with a positive FOBT were referred to the gastroenterology service. In 70.5% of patients, FOBT could be considered inappropriate because of factors such as age, active GI bleeding, or use of aspirin or other nonsteroidal anti-inflammatory drugs. The FOBT, which is validated only for colorectal ca...Continue Reading

References

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Jul 14, 2000·The American Journal of Gastroenterology·V K SharmaC W Howden

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Citations

Sep 12, 2012·Annals of Family Medicine·Richard G RoetzheimEllen P McCarthy
Sep 24, 2015·Hospital Practice·Lucia PonorScott Wright
Aug 2, 2003·Advances in Neonatal Care : Official Journal of the National Association of Neonatal Nurses·Joaquim M B PinheiroKathleen G Benjamin
Oct 26, 2006·Journal of Clinical Gastroenterology·Charles D ScalesDon C Rockey
Feb 15, 2020·The American Journal of Gastroenterology·AbdulRazaq Sokoro, Harminder Singh
Dec 22, 2009·Internal Medicine Journal·A FriedmanP R Gibson
Sep 5, 2019·BMC Gastroenterology·Sarthak SoinNasir Saleem
Aug 9, 2012·European Journal of Gastroenterology & Hepatology·Oliver PeacockJonathan N Lund
Mar 8, 2008·Annals of Clinical Biochemistry·Callum G Fraser

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