FOCUS: Future of fecal calprotectin utility study in inflammatory bowel disease.
OBJECTIVE
To evaluate the perspective of gastroenterologists regarding the impact of fecal calprotectin (FC) on the management of patients with inflammatory bowel disease (IBD).


METHODS
Patients with known IBD or symptoms suggestive of IBD for whom the physician identified that FC would be clinically useful were recruited. Physicians completed an online "pre survey" outlining their rationale for the test. After receipt of the test results, the physicians completed an online "post survey" to portray their perceived impact of the test result on patient management. Clinical outcomes for a subset of patients with follow-up data available beyond the completion of the "post survey" were collected and analyzed.


RESULTS
Of 373 test kits distributed, 290 were returned, resulting in 279 fully completed surveys. One hundred and ninety patients were known to have IBD; 147 (77%) with Crohn's Disease, 43 (21%) Ulcerative Colitis and 5 (2%) IBD unclassified. Indications for FC testing included: 90 (32.2%) to differentiate a new diagnosis of IBD from Irritable Bowel Syndrome (IBS), 85 (30.5%) to distinguish symptoms of IBS from IBD in those known to have IBD and 104 (37.2%) as an objective measure of inflammation. FC levels resulted in a change in management 51.3% (143/279) of the time which included a significant reduction in the number of colonoscopies (118) performed (P < 0.001). Overall, 97.5% (272/279) of the time, the physicians found the test sufficiently useful that they would order it again in similar situations. Follow-up data was available for 172 patients with further support for the clinical utility of FC provided.


CONCLUSIONS
The FC test effected a change in management 51.3% of the time and receipt of the result was associated with a reduction in the number of colonoscopies performed.
Greg Rosenfeld, Astrid-Jane Greenup, Andrew Round, Oliver Takach, Lawrence Halparin, Robert Enns, Brian Bressler, Department of Medicine, Division of Gastroenterology, St. Paul's Hospital, University of British Columbia, Vancouver, BC V6Z 2K5, Canada.
Greg
G
Rosenfeld
Greg Rosenfeld, Astrid-Jane Greenup, Andrew Round, Oliver Takach, Lawrence Halparin, Robert Enns, Brian Bressler, Department of Medicine, Division of Gastroenterology, St. Paul's Hospital, University of British Columbia, Vancouver, BC V6Z 2K5, Canada.
Astrid-Jane
AJ
Greenup
Greg Rosenfeld, Astrid-Jane Greenup, Andrew Round, Oliver Takach, Lawrence Halparin, Robert Enns, Brian Bressler, Department of Medicine, Division of Gastroenterology, St. Paul's Hospital, University of British Columbia, Vancouver, BC V6Z 2K5, Canada.
Andrew
A
Round
Greg Rosenfeld, Astrid-Jane Greenup, Andrew Round, Oliver Takach, Lawrence Halparin, Robert Enns, Brian Bressler, Department of Medicine, Division of Gastroenterology, St. Paul's Hospital, University of British Columbia, Vancouver, BC V6Z 2K5, Canada.
Oliver
O
Takach
Greg Rosenfeld, Astrid-Jane Greenup, Andrew Round, Oliver Takach, Lawrence Halparin, Robert Enns, Brian Bressler, Department of Medicine, Division of Gastroenterology, St. Paul's Hospital, University of British Columbia, Vancouver, BC V6Z 2K5, Canada.
Lawrence
L
Halparin
Greg Rosenfeld, Astrid-Jane Greenup, Andrew Round, Oliver Takach, Lawrence Halparin, Robert Enns, Brian Bressler, Department of Medicine, Division of Gastroenterology, St. Paul's Hospital, University of British Columbia, Vancouver, BC V6Z 2K5, Canada.
Abid
A
Saadeddin
Greg Rosenfeld, Astrid-Jane Greenup, Andrew Round, Oliver Takach, Lawrence Halparin, Robert Enns, Brian Bressler, Department of Medicine, Division of Gastroenterology, St. Paul's Hospital, University of British Columbia, Vancouver, BC V6Z 2K5, Canada.
Jin Kee
JK
Ho
Greg Rosenfeld, Astrid-Jane Greenup, Andrew Round, Oliver Takach, Lawrence Halparin, Robert Enns, Brian Bressler, Department of Medicine, Division of Gastroenterology, St. Paul's Hospital, University of British Columbia, Vancouver, BC V6Z 2K5, Canada.
Terry
T
Lee
Greg Rosenfeld, Astrid-Jane Greenup, Andrew Round, Oliver Takach, Lawrence Halparin, Robert Enns, Brian Bressler, Department of Medicine, Division of Gastroenterology, St. Paul's Hospital, University of British Columbia, Vancouver, BC V6Z 2K5, Canada.
Robert
R
Enns
Greg Rosenfeld, Astrid-Jane Greenup, Andrew Round, Oliver Takach, Lawrence Halparin, Robert Enns, Brian Bressler, Department of Medicine, Division of Gastroenterology, St. Paul's Hospital, University of British Columbia, Vancouver, BC V6Z 2K5, Canada.
Brian
B
Bressler
D000328:Adult; D000368:Aged; D015415:Biomarkers / Q000737:chemistry; D001955:British Columbia; D003093:Colitis, Ulcerative / Q000175:diagnosis* / Q000378:metabolism; D003113:Colonoscopy; D003424:Crohn Disease / Q000175:diagnosis* / Q000378:metabolism; D005243:Feces / Q000737:chemistry*; D005260:Female; D006801:Humans; D007249:Inflammation; D015212:Inflammatory Bowel Diseases / Q000175:diagnosis* / Q000378:metabolism; D039841:Leukocyte L1 Antigen Complex / Q000737:chemistry*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D016896:Treatment Outcome; D055815:Young Adult
D015415:Biomarkers; D039841:Leukocyte L1 Antigen Complex
Biomarkers; Colonoscopy; Fecal calprotectin; Inflammatory bowel disease; Physician perspective
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