title: Use of fecal occult blood testing in hospitalized patients: results of an audit.
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.
authors.forename: Stephen
authors.initials: S
authors.lastname: Ip
authors.forename: AbdulRazaq A H
authors.initials: AA
authors.lastname: Sokoro
authors.forename: Lisa
authors.initials: L
authors.lastname: Kaita
authors.forename: Claudia
authors.initials: C
authors.lastname: Ruiz
authors.forename: Elaine
authors.initials: E
authors.lastname: McIntyre
authors.forename: Harminder
authors.initials: H
authors.lastname: Singh
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D003113:Colonoscopy; D015179:Colorectal Neoplasms / Q000175:diagnosis*; D055088:Early Detection of Cancer / Q000379:methods; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007297:Inpatients; D008297:Male; D008350:Manitoba; D008403:Mass Screening; D008485:Medical Audit; D009780:Occult Blood; D010818:Practice Patterns, Physicians'