An audit of the utility of in-patient fecal occult blood testing

Sharma, Virender K.; Komanduri, Sri; Nayyar, Sanjay; Headly, Anna; Modlinger, Paul; Metz, David C.; Verghese, Vino J; Wanahita, Anna; Go, Mae F.; Howden, Colin W.

doi:10.1016/s0002-9270(01)02272-9

Cited by 15 publications

(23 citation statements)

References 8 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…[39][40][41][42][43][44][45][46][47][48] We therefore examined Medicare claims (National Claims History, NCH) for the following ambulatory-based evaluation and management services representing routine offi ce visits: 99201-99205, 99211-99215.…”

Section: Methodsmentioning

confidence: 99%

Influence of Primary Care on Breast Cancer Outcomes Among Medicare Beneficiaries

Roetzheim

Ferrante

Lee

et al. 2012

The Annals of Family Medicine

View full text Add to dashboard Cite

PURPOSE We used the Surveillance Epidemiology and End Results (SEER)-Medicare database to explore the association between primary care and breast cancer outcomes.METHODS Using a retrospective cohort study of 105,105 female Medicare benefi ciaries with a diagnosis of breast cancer in SEER registries during the years 1994-2005, we examined the total number of offi ce visits to primary care physicians and non-primary care physicians in a 24-month period before cancer diagnosis. For women with invasive cancers, we examined the odds of diagnosis of late-stage disease, according to the American Joint Commission on Cancer (AJCC) (stages III and IV vs stages I and II), and survival (breast cancer specifi c and all cause) using logistic regression and proportional hazards models, respectively. We also explored whether including noninvasive cancers, such as ductal carcinoma in situ (DCIS), would alter results and whether prior mammography was a potential mediator of associations.RESULTS Primary care physician visits were associated with improved breast cancer outcomes, including greater use of mammography, reduced odds of latestage diagnosis, and lower breast cancer and overall mortality. Prior mammography (and resultant earlier stage diagnosis) mediated these associations in part, but not completely. Similar results were seen for non-primary care physician visits. Results were similar when women with DCIS were included in the analysis.CONCLUSIONS Medicare benefi ciaries with breast cancer had better outcomes if they made greater use of a primary care physician's ambulatory services. These fi ndings suggest adequate primary medical care may be an important factor in achieving optimal breast cancer outcomes.

show abstract

Section: Methodsmentioning

confidence: 99%

Influence of Primary Care on Breast Cancer Outcomes Among Medicare Beneficiaries

Roetzheim

Ferrante

Lee

et al. 2012

The Annals of Family Medicine

View full text Add to dashboard Cite

show abstract

“…However, several retrospective studies have shown that only 17% to 45% of patients admitted to the hospital have a DRE documented in the medical record. 21,25,26 Although our prospective study showed that a DRE was performed in a higher proportion of patients admitted to the hospital, a substantial number of individuals were not examined.…”

Section: Discussionmentioning

confidence: 92%

“…Furthermore, this practice has been taught to medical students and house officers and has become the standard of practice found in current physical diagnosis textbooks. [17][18][19][20] Although testing stool obtained during a DRE for occult blood at the time of admission to the hospital is often performed, 21 the practice of admission stool guaiac (ASG) testing has not been evaluated prospectively. Therefore, the aims of this prospective cohort study were to determine the proportion of patients that had a DRE and ASG testing performed at the time of hospital admission and to evaluate the frequency of positive ASG tests.…”

mentioning

confidence: 99%

Prospective Evaluation of the Use and Outcome of Admission Stool Guaiac Testing: The Digital Rectal Examination on Admission to the Medical Service (DREAMS) Study

Bini¹,

Reinhold²,

Weinshel³

et al. 2006

Journal of Clinical Gastroenterology

View full text Add to dashboard Cite

show abstract

“…1 Although only recommended in the context of colon cancer screening, 2 FOBT is frequently ordered in the inpatient setting due to anemia, 3 and is a common reason for inpatient gastroenterology consultation. 4 Because of its false positive results, inpatient guaiac testing commonly leads to negative endoscopic testing, 4,5 and has been shown to have little beneficial impact on inpatient clinical management. 6 In fact, despite endoscopic evaluation with upper esophagogastroduodenoscopy (EGD) and colonoscopy, the source of bleeding can remain undetected in patients with occult GIB in up to 52% of patients.…”

Section: Introductionmentioning

confidence: 99%

Predictors of positive endoscopic findings in hospitalized patients with occult gastrointestinal bleeding

Sengupta

Tapper

Patwardhan

et al. 2015

Gastroenterol Insights

View full text Add to dashboard Cite

Anemia with occult gastrointestinal bleeding (OGIB) is a common reason for inpatient gastroenterology consultation and endoscopy. However, the utility of inpatient endoscopy in this setting is unclear. The aim of this paper is to determine variables that predict positive endoscopic examinations for inpatients presenting with anemia and OGIB. We performed a prospective observational study of consecutive hospitalized patients between March 2013 and April 2014 with anemia and OGIB. For patients undergoing inpatient endoscopic evaluation, logistic regression was used to determine which variables were associated with detecting etiology of OGIB. An occult bleeding score (OBS) was created using receiver operating characteristics and area under the curve (AUC) analysis to predict detection of bleeding source and need for endoscopic intervention. Of the 74 patients identified, 55 (74%) underwent endoscopic evaluation, of whom 28 patients had a source of OGIB identified. Patients with malignancy (OR 7.25, 95%CI 1.06-144) were more likely to have a bleeding source identified on endoscopy, whereas patients with higher admission hemoglobin levels were less likely to have a detected source (OR 0.62, 95%CI 0.41-0.86). The OBS was constructed by assigning a point each for malignancy and admission hemoglobin <8.2 g/dL. The OBS predicted detection of etiology of bleeding and endoscopic intervention with an AUC of 0.79 and 0.75. The yield of endoscopy in determining a bleeding source in patients with OGIB is significant particularly in patients with malignancy or a low hemoglobin level. A simple score can assist in determining whether inpatient endoscopy is warranted in this population.

show abstract

An audit of the utility of in-patient fecal occult blood testing

Cited by 15 publications

References 8 publications

Influence of Primary Care on Breast Cancer Outcomes Among Medicare Beneficiaries

Influence of Primary Care on Breast Cancer Outcomes Among Medicare Beneficiaries

Prospective Evaluation of the Use and Outcome of Admission Stool Guaiac Testing: The Digital Rectal Examination on Admission to the Medical Service (DREAMS) Study

Predictors of positive endoscopic findings in hospitalized patients with occult gastrointestinal bleeding

Contact Info

Product

Resources

About