From FOBt to FIT: making it work for patients and populations

Mole, Guy; Withington, John; Logan, R. P. H.

doi:10.7861/clinmedicine.19-3-196

Cited by 6 publications

(7 citation statements)

References 10 publications

(9 reference statements)

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“…It would therefore appear that whatever strategy is used, bleeding from a lesion may be inconsistent and any single sample will, on average, detect with the same degree of diagnostic accuracy. Of note, previous studies of FIT in symptomatic patients have noted a small number of false negatives (4). In a recent study (17) using FIT in a symptomatic population in a 2 week wait pathway 12.5% of colorectal cancers were missed using a single patient collected specimen using a threshold of 10 µg/g.…”

Section: Comparisons To Previous Literaturementioning

confidence: 89%

“…There is on-going debate as to how FIT results should be reported from those that consider the result as "detected"/"not detected" through to quantitative reporting of numeric values (4,7). Given the high imprecision of analysis when sampling is taken into consideration we would caution against quantitative reporting of faecal Hb due to the high uncertainty of measurement.…”

Section: Implications For Research and Practicementioning

confidence: 99%

“…To complement the UK Bowel Cancer Screening Programme (UKBCSP), the 2017 DG30 NICE guidance (3) recommended the use of FIT for faecal haemoglobin (Hb) detection in patients presenting to primary care with low risk abdominal symptoms. The adoption of FIT in primary care has been slow, with notable variation in uptake and implementation across the UK (4). The Oxford University Hospitals Trust (OUH) adopted FIT prior to the DG30 guidance to comply with the 2015 NG12 NICE guidance for suspected cancer (6), which recommended the use of faecal occult blood testing in symptomatic patients.…”

Section: Introductionmentioning

confidence: 99%

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Faecal immunochemical testing (FIT): Sources of analytical variation based on three years of routine testing in the context of DG30

James

Nicholson

Marr

et al. 2020

Preprint

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words)Aims: To determine analytical capabilities of a commonly used faecal immunochemical test (FIT) to detect haemoglobin (Hb) in the context of NICE guidance DG30, and the likely use of FIT to reprioritise patients delayed by the COVID-19 pandemic.Methods: Data obtained from independent verification studies and clinical testing of the HM-JACKarc FIT method in routine primary care practice were analysed to derive analytical performance characteristics.Results: Detection capabilities for the FIT method were 0.5 µg/g (limit of blank), 1.1 (limit of detection) and 15.0 µg/g (limit of quantification). 31 of 33 (94%) non-homogenised specimens analysed in triplicate were consistently categorised relative to 10 µg/g compared to all 33 (100%) homogenised specimens. Imprecision in non-homogenised specimens was higher (median 27.8%, (range 20.5% -48.6%)) than in homogenised specimens (10.

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Section: Comparisons To Previous Literaturementioning

confidence: 89%

Section: Implications For Research and Practicementioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Faecal immunochemical testing (FIT): Sources of analytical variation based on three years of routine testing in the context of DG30

James

Nicholson

Marr

et al. 2020

Preprint

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“…Faecal occult blood or Faecal immunochemical tests (FITs) have been used to triage 2WW lower GI suspected cancer referrals[ 117 ]. In 2019, six United Kingdom ‘FIT pioneer sites’ shared data regarding FIT positive and negative cancers, in a combined 9182 patients[ 118 ]. The number of FIT negative cancers was 0.01%-0.75%, with a negative predictive value of at least 99.05%.…”

Section: Proposals For Gastroenterology and Hepatology Service-planning And Training Provision During The Covid-19 Pandemic And Beyondmentioning

confidence: 99%

COVID-19: Effect on gastroenterology and hepatology service provision and training: Lessons learnt and planning for the future

Anjum¹,

Chalmers²,

Hamid³

et al. 2021

WJG

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In late 2019, reports arose of a new respiratory disease in China, identified as a novel coronavirus, severe acute respiratory syndrome coronavirus 2. The World Health Organisation named the disease caused by the virus ‘coronavirus disease 2019 (COVID-19)’. It was declared a pandemic in early 2020, after the disease rapidly spread across the world. COVID-19 has not only resulted in substantial morbidity and mortality but also significantly impacted healthcare service provision and training across all medical specialties with gastroenterology and Hepatology services being no exception. Internationally, most, if not all ‘non-urgent’ services have been placed on hold during surges of infections. As a result there have been delayed diagnoses, procedures, and surgeries which will undoubtedly result in increased morbidity and mortality. Outpatient services have been converted to remote consultations where possible in many countries. Trainees have been redeployed to help care for COVID-19 patients in other settings, resulting in disruption to their training - particularly endoscopy and outpatient clinics. This has led to significant anxiety amongst trainees, and risks prolongation of training. It is of the utmost importance to develop strategies that continue to support COVID-19-related service provision, whilst also supporting existing and future gastroenterology and Hepatology services and training. Changes to healthcare provision during the pandemic have generated new and improved frameworks of service and training delivery, which can be adopted in the post-COVID-19 world, leading to enhanced patient care.

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“…The Royal College of Physicians (RCP) hosted a conference at which cutting-edge data on the contentious topic of setting the cut-off level for the test was presented. An excellent summary of this data is presented in this edition of the journal, 1 allowing the reader to consider the importance of the negative predictive value of these large data sets, and using that to shape colonoscopy practice based on local services and case mix. The article is accompanied by an excellent editorial by the team at Imperial College making the case that, correctly used, the test may indeed be 'FIT' for purpose.…”

mentioning

confidence: 99%

More a hammer than a mirror

Emmanuel¹

2019

Clinical Medicine

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From FOBt to FIT: making it work for patients and populations

Cited by 6 publications

References 10 publications

Faecal immunochemical testing (FIT): Sources of analytical variation based on three years of routine testing in the context of DG30

Faecal immunochemical testing (FIT): Sources of analytical variation based on three years of routine testing in the context of DG30

COVID-19: Effect on gastroenterology and hepatology service provision and training: Lessons learnt and planning for the future

More a hammer than a mirror

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