Krysti is a first year basic trainee at Cairns Hospital, Queensland. She has a big interest in research, and this is her second presentation at an IMSANZ conference.
The Overuse Of Inpatient Faecal Occult Blood Testing: Time To Change Clinical Practice
Faecal occult blood testing (FOBT) is a population-based screening tool used in asymptomatic patients.1 It has been validated to detect colorectal lesions early through the presence of occult blood in the stool in a primary care setting.1There is a lack of evidence to illustrate a clinical indication for FOBT in symptomatic patients, as well as concerns for its effectiveness in identifying other gastrointestinal bleeding and use with hospital inpatients 2-4
It is important for clinical measurements and quality assurance that every investigation ordered can be justified, in respect to the financial costs, added stress on the patient and impact on patient management. Therefore, with the ease of ordering investigations within the hospital setting, more investigations does not necessarily lead to better clinical outcomes.
The aim of this study is to understand the use of FOBT in the hospital setting and suggest strategies to limit the use of FOBT to only clinically appropriate settings.
Friedman A, Chane LC, Chin A et al. Use and abuse of faecal occult blood tests in an acute hospital inpatient setting. Inter Med J. 2010. 40; 107-111. DOI: 10.1111/j.1445-5994.2009.02149.x
Ottawa O: CADTH Rapid Response Reports. Urgent, non-screening fecal occult blood testing for patients with suspected gastrointestinal bleeding: A review of clinical effectiveness and guidelines. Canadian Agency for Drugs ad Technologies in Health. Jan 2017. https://www.ncbi.nlm.nih.gov/pubmed/28727402.
Narula N, Ulic D, Al-Dabbagh E et al. Fecal occult blood testing as a diagnostic test in symptomatic patients is not useful: A retrospective chart review. Can J Gastroenterol Hepatol. Sep 2014. 28 (8):421-426.