Survey of Emergency Department Clinicians on the Utility of the Guaiac Fecal Occult Blood Test

Emergency department (ED) clinicians utilize the guaiac fecal occult blood test (gFOBT) in their assessment of suspected gastrointestinal bleeding or unexplained anemia despite supporting evidence. ED clinicians' ability to predict the gFOBT results and how the gFOBT results could affect ED pat...

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Bibliographic Details
Published in:Curēus (Palo Alto, CA) CA), 2024-10, Vol.16 (10), p.e70922
Main Authors: Shirazi, Ehsan, Lalljie, Albertha V, Heckman, Michael G, Hochwald, Alexander, Hamid, Osman, Mohammed, Elmkdad, Sheele, Johnathan M
Format: Article
Language:English
Subjects:
Blood pressure
Blood tests
Colorectal cancer
Emergency medical care
Emergency Medicine
Feces
Gastroenterology
Hemoglobin
Internal Medicine
Medical screening
Patients
Polls & surveys
Statistical analysis
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Summary:Emergency department (ED) clinicians utilize the guaiac fecal occult blood test (gFOBT) in their assessment of suspected gastrointestinal bleeding or unexplained anemia despite supporting evidence. ED clinicians' ability to predict the gFOBT results and how the gFOBT results could affect ED patient disposition has not been previously studied.  Methods: From October 16, 2019, through September 15, 2020, we conducted a single-site survey of ED clinicians before and after performing gFOBTs during routine clinical care. Survey data were collected and retrospectively evaluated with unadjusted and multivariable regression analyses. We examined a total of 133 combined pre-gFOBT and post-gFOBT surveys. ED clinicians accurately predicted gFOBT results with an area under the receiver operating characteristic curve of 0.75 (95%CI, 0.66-0.85). Of clinician-predicted certain or very probable positive gFOBT results, only 79% were actually positive. In multivariable analyses, decreased hematocrit level (odds ratio (OR), 0.31/10% increase; 95%CI, 0.14-0.61), decreased red blood cell count (OR, 0.41/1x10 /L increase; 95%CI, 0.21-0.75), and absence of firm stool consistency (OR, 0.09; 95%CI, 0.01-0.42) were associated with positive gFOBT results (all P
ISSN:2168-8184
2168-8184
DOI:10.7759/cureus.70922