Fecal Calprotectin Test Performed at Home

Piekkala, Maija; Alfthan, Henrik; Merras‐Salmio, Laura; Puustinen, Anne; Heiskanen, Kaarina; Jaakkola, Tytti; Klemetti, Paula; Färkkilä, Martti; Kolho, Kaija‐Leena

doi:10.1097/mpg.0000000000001861

Cited by 16 publications

(14 citation statements)

References 28 publications

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“…The possibility to measure calprotectin with a smartphone at home is a novelty in IBD-care. We identified three recently published studies on the IB Doc home test, [7, 9, 10] and one on the CalproSmart home test. [11] All studies showed acceptable agreement between home test and companion ELISA in the low range and lack of agreement in the high range.…”

Section: Discussionmentioning

confidence: 99%

“…Third, in this study we report an a priori decision of acceptable limits of difference for adequate interpretation of the Bland-Altman plot, a feature that was absent in three of the aforementioned studies. [9–11] Precision is of utmost importance in the low ranges of calprotectin values, where small deviations can lead to misclassification of disease activity and wrong treatment decisions. In our practice, however, imprecision in the high range is less of an issue, since we consider each calprotectin result >500 μg/g to reflect active disease, irrespective of the absolute concentration.…”

Section: Discussionmentioning

confidence: 99%

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Head-to-head comparison of three stool calprotectin tests for home use

et al. 2019

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Objective Treatment decisions in inflammatory bowel diseases are increasingly based on longitudinal tracking of calprotectin results. Many hospital laboratories measure calprotectin levels in sent-in stool samples with an enzyme-linked immunosorbent assay (ELISA). Several manufacturers introduced a lateral flow–based test with software application that turns a smartphone camera into a reader for quantitative measurements. We compared three home tests (IB Doc , QuantonCal and CalproSmart) and companion ELISA tests (fCAL, IDK-Calprotectin and Calprotectin-ALP) to see if measurement pairs agreed sufficiently. Design A method comparison study was conducted with stool samples from patients with active or quiescent inflammatory bowel disease. Medical students without any specific laboratory training carried out the home tests with two iOS (iPhone 6 and 7) and two Android devices (Samsung Galaxy S6 and Motorola Moto G5 Plus). Two experienced laboratory technicians measured the calprotectin concentration with the ELISA method. Primary outcome was test agreement (defined as percentage of paired measurements within predefined limits of difference). Secondary outcome included reading error rate (RER) per smartphone type. Results We performed 1440 smartphone readings and 120 ELISA tests. In the low calprotectin range (≤500 μg/g) IB Doc , QuantOnCal and CalproSmart showed 87%, 82% and 76% agreement with their companion ELISAs. In the high range (>500 μg/g) the agreement was 37%, 19% and 37%, respectively. CalproSmart and QuantOnCal had significantly higher RERs than IB Doc (respectively 5.8% and 4.8%, versus 1.9%). Forty-three percent of reading errors was on the Motorola device, in particular with the QuantOnCal application. Conclusions All three calprotectin home tests and companion ELISAs agreed sufficiently when concentrations are ≤500 μg/g. To minimize wrongful interpretation of calprotectin changes over time it is essential to always use the home test and companion ELISA of one and the same manufacturer. Manufacturers should explicitly evaluate and report the suitability of commonly used smartphones for quantitative calprotectin readings.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Head-to-head comparison of three stool calprotectin tests for home use

et al. 2019

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“…The IBDoc (Laboratories AG, Baselstrasse 55, CH-4124 Schönenbuch, Switzerland) home kit was selected owing to its wide usage in various countries, including some National Health Service (NHS) trusts, [5][6][7][8] and as a kit which, when tested, was found to agree with ELISA tests at calprotectin levels <500 µg/g. 9 10…”

Section: Summary Boxmentioning

confidence: 99%

Point-of-care faecal calprotectin testing in patients with paediatric inflammatory bowel disease during the COVID-19 pandemic

Jere

Garrick

Curtis

et al. 2021

BMJ Open Gastroenterol

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ObjectivesFollowing the disruption of normal paediatric inflammatory bowel disease (IBD) services during the peak of the COVID-19 pandemic, we prospectively audited the first-time use of home faecal calprotectin testing. We aimed to provide an alternative to laboratory tests and to assess the value of home testing as part of our regular services going forward.MethodsHome test kits as well as accompanying user instructions were made available to our patients with paediatric IBD that required faecal calprotectin test between 17 April and 12 August 2020. Once the user completed the test, results were automatically uploaded to the result portal and clinical staff were alerted. A user feedback questionnaire was sent to users that had completed the home test.ResultsOf the 54 patients, 41 (76%) aged between 4.7 and 18.1 years used the home test. A total of 45 home tests were done, one of which produced an invalid result. The decision to modify management was made in 12 (29%) of the patients, while 14 (34%) had no changes made and 15 (37%) required further assessment. Twenty (48.8%) responded to the questionnaire and 85% stated that they preferred the home test to the laboratory testing method.ConclusionsHome calprotectin tests were useful in guiding clinical management during a time when laboratory testing was less available. They may offer benefits as part of routine paediatric IBD monitoring to help target appointments and reduce unnecessary hospital attendances in the future.

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“…An investigation into the feasibility of home FC testing concluded that 80% of parents felt this method would improve disease management, however, the practicality of using them was difficult for over half. 32 This method of testing allows for greater patient empowerment with reduced embarrassment, especially for adolescents, perhaps leading to better compliance. The technology also allows smartphone apps to communicate results directly and immediately to the patient's MDTs, increasing efficiency and potentially also the speed of clinical reaction to elevated results.…”

Section: Role Of the Mdtmentioning

confidence: 99%

Impact of COVID-19 on the diagnosis, assessment and management of children with inflammatory bowel disease in the UK: implications for practice

Maclean

Ashton

Garrick

et al. 2020

bmjpo

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The assessment and management of patients with known, or suspected, paediatric inflammatory bowel disease (PIBD) has been hugely impacted by the COVID-19 pandemic. Although current evidence of the impact of COVID-19 infection in children with PIBD has provided a degree of reassurance, there continues to be the potential for significant secondary harm caused by the changes to normal working practices and reorganisation of services.Disruption to the normal running of diagnostic and assessment procedures, such as endoscopy, has resulted in the potential for secondary harm to patients including delayed diagnosis and delay in treatment. Difficult management decisions have been made in order to minimise COVID-19 risk for this patient group while avoiding harm. Initiating and continuing immunosuppressive and biological therapies in the absence of normal surveillance and diagnostic procedures have posed many challenges.Despite this, changes to working practices, including virtual clinic appointments, home faecal calprotectin testing kits and continued intensive support from clinical nurse specialists and other members of the multidisciplinary team, have resulted in patients still receiving a high standard of care, with those who require face-to-face intervention being highlighted.These changes have the potential to revolutionise the way in which patients receive routine care in the future, with the inclusion of telemedicine increasingly attractive for stable patients. There is also the need to use lessons learnt from this pandemic to plan for a possible second wave, or future pandemics as well as implementing some permanent changes to normal working practices.In this review, we describe the diagnosis, management and direct impact of COVID-19 in paediatric patients with IBD. We summarise the guidance and describe the implemented changes, evolving evidence and the implications of this virus on paediatric patients with IBD and working practices.

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Fecal Calprotectin Test Performed at Home

Abstract: PIBD patients and their families were interested in FC home monitoring and willing to adopt testing as a part of their disease management, but this approach requires thorough guidance.

Cited by 16 publications

References 28 publications

Head-to-head comparison of three stool calprotectin tests for home use

Head-to-head comparison of three stool calprotectin tests for home use

Point-of-care faecal calprotectin testing in patients with paediatric inflammatory bowel disease during the COVID-19 pandemic

Impact of COVID-19 on the diagnosis, assessment and management of children with inflammatory bowel disease in the UK: implications for practice

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