Development and evaluation of a risk assessment tool to improve clinical triage accuracy for colonoscopic investigations

BMC Cancer
Anton R LordGraham L Radford-Smith

Abstract

Gastroenterology Departments at hospitals within Australia receive thousands of General Practitioner (GP)-referral letters for gastrointestinal investigations every month. Many of these requests are for colonoscopy. This study aims to evaluate the performance of the current symptoms-based triage system compared to a novel risk score using objective markers. Patients with lower abdominal symptoms referred by their GPs and triaged by a Gastroenterology consultant to a colonoscopy consent clinic were recruited into the study. A risk assessment tool (RAT) was developed using objective data (clinical, demographic, pathology (stool test, FIT), standard blood tests and colonoscopy outcome). Colonoscopy and histology results were scored and then stratified as either significant bowel disease (SBD) or non-significant bowel disease (non-SBD). Of the 467 patients in our study, 45.1% were male, the mean age was 54.3 ± 13.8 years and mean BMI was 27.8 ± 6.2. Overall, 26% had SBD compared to 74% with non-SBD (42% of the cohort had a normal colonoscopy). Increasing severity of referral symptoms was related to a higher triage category, (rectal bleeding, P = 2.86*10-9; diarrhoea, P = 0.026; abdominal pain, P = 5.67*10-4). However, there was no ...Continue Reading

References

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Citations

Mar 1, 2019·Internal Medicine Journal·Thomas M ElliottLouisa G Gordon
Jun 15, 2021·JGH Open : an Open Access Journal of Gastroenterology and Hepatology·Yee Man KanChing Kong Loo
Jan 20, 2021·Internal Medicine Journal·Jon D EmeryAlan Moss

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Methods Mentioned

BETA
biopsies
RAT

Software Mentioned

fmrb
rpart
R

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