INTRODUCTION Fecal calprotectin (Fcal) is a non-invasive, inexpensive biomarker of disease activity. However, patient compliance with this test is variable and incompletely described. We assessed compliance rates with Fcal tests and identified factors associated with non-compliance. METHODS A retrospective chart review of patients with IBD who had a Fcal test ordered through our center between August 2021 and December 2021 was conducted. Demographic, clinical, disease, and test-related information were recorded. Patients with incomplete Fcal orders were sent a survey to better understand their reasons for non- compliance. Simple statistical analysis, multivariable logistic regression, and Bayesian Factor Analysis were performed. RESULTS Of 303 patients, 165 (54.4%) had an order for Fcal. Of the Fcal tests ordered, 55 (33.3%) were not completed. Remission of IBD, no prior Fcal completion, and tests ordered at a distant site were all associated with test non-completion. A multivariable logistic regression revealed that history of a prior completed Fcal test is associated with subsequent test completion (OR = 8.3, 95% CI 1.9-35.5, p = 0.004). Patients who did not complete the test described the pandemic and third-party testing center issues as the most common reasons for non-compliance. CONCLUSIONS In this single center experience with Fcal testing in patients with IBD, we identified that a history of incomplete Fcal testing and distant location of the lab are significantly associated with non- completion of the test. We provide practical guidance for future utilization and compliance, including the impact of home-based testing.
Introduction: Recent clinical trials have assessed the efficacy and safety of Etrolizumab in treatment of ulcerative colitis. Aim: To assess the efficacy and safety of Etrolizumab for induction and maintenance of remission in moderate to severe ulcerative colitis. Methods: We searched the following databases: PUBMED, Web Of Science, OVID, and SCOPUS in 15 January 2022. Inclusion criteria were any phase 2 and 3 clinical trials that compare Etrolizumab with placebo in treatment of moderate to severe ulcerative colitis, excluding case reports, animal studies, phase 1 trials, and conference abstracts. We used RevMan software (5.4) for the meta-analysis. Results: Five clinical trials were included in our meta-analysis. The total number of patients included in the study is 1249 patients, 960 patients in the Etrolizumab group, and 399 patients in the placebo group. In the induction phase, the pooled analyses showed a statistically significant association between Etrolizumab and increased clinical remission, and endoscopic remission compared with placebo (RR5 2.66, [95% CI5 1.69 to 4.19], P , 0.0001), and (RR5 2.35, [95% CI5 1.52 to 3.65], P 5 0.0001). In the maintenance phase, the pooled analyses showed a statistically significant association between Etrolizumab and increased histologic remission and endoscopic remission (RR5 2.04, [95% CI5 1.40 to 2.99], P 5 0.0002) and (RR5 1.92, [95% CI5 1.29 to 2.95], P 5 0.001). No statistically significant difference was observed in adverse events between Etrolizumab and placebo in induction and maintenance phases. Conclusion: Our results show that Etrolizumab is an effective and safe drug for the induction and maintenance of clinical remission in moderate to severe ulcerative colitis patients proved by histologic and endoscopic findings. Future randomized trials are still needed to compare Etrolizumab to the other agents and further establish its value for the practice.
Introduction: There is a lack of qualitative analysis of the personal experiences within Couples Matching. In this qualitative study, we aim to record personal attitudes, reflections, and advice on experiences with the Couples Match process.Methods: Our survey, consisting of two open-ended questions regarding the experience of Couples Matching, was distributed from January 2022 to March 2022 via email to 106 otolaryngology program directors across the nation. Survey responses were analyzed iteratively using the constructivist grounded theory to construct themes related to pre-match priorities, match-related stressors, and post-match satisfaction.Themes were developed inductively and refined iteratively as the dataset evolved.Results: 18 Couples Match residents responded. In response to the first question:"What was the most difficult part of the process for you and/or your partner?", we identified the following themes: cost and financial burden, increased stress on the relationship, sacrificing top choices, and finalizing the match list. In response to the second question: "Using your experience as a previous applicant, what advice would you give to another couple planning on couples matching?", we identified four common themes: compromise, advocacy, dynamic conversations, and applying broadly. Conclusion:We sought to understand the Couples Match process through the perspective of previous applicants. Analyzing the views and attitudes of Couples Match applicants, our study captures the most challenging aspects of the experience and highlights possible areas to improve advising for couples, including important factors to consider when applying, ranking, and interviewing.
KEY POINTS We use machine learning to examine health insurance and mortality in olfactory neuroblastoma. Private insurance significantly improved survival even after adjusting for confounders. The regression model also found no statistical difference between Medicare and no insurance.
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