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Primary care faecal calprotectin testing in children with suspected inflammatory bowel disease: a diagnostic accuracy study.
Walker, Gareth J; Chanchlani, Neil; Thomas, Amanda; Lin, Simeng; Moore, Lucy; Heerasing, Neel M; Hendy, Peter; Abdelrahim, Mohamed; Mole, Sean; Perry, Mandy H; Mcdonald, Timothy J; Bewshea, Claire M; Hart, James W; Russell, Richard K; Ahmad, Tariq; Goodhand, James R; Kennedy, Nicholas A.
Afiliação
  • Walker GJ; Gastroenterology, Royal Devon and Exeter Hospital, Exeter, UK.
  • Chanchlani N; Exeter IBD Pharmacogenetics, University of Exeter Medical School, Exeter, UK.
  • Thomas A; Exeter IBD Pharmacogenetics, University of Exeter Medical School, Exeter, UK.
  • Lin S; Paediatrics, Royal Devon and Exeter Hospital, Exeter, UK.
  • Moore L; Gastroenterology, Royal Devon and Exeter Hospital, Exeter, UK.
  • Heerasing NM; Exeter IBD Pharmacogenetics, University of Exeter Medical School, Exeter, UK.
  • Hendy P; Gastroenterology, Royal Devon and Exeter Hospital, Exeter, UK.
  • Abdelrahim M; Exeter IBD Pharmacogenetics, University of Exeter Medical School, Exeter, UK.
  • Mole S; The College of Medicine & Health, University of Exeter, Exeter, UK.
  • Perry MH; Gastroenterology, Royal Devon and Exeter Hospital, Exeter, UK.
  • Mcdonald TJ; Exeter IBD Pharmacogenetics, University of Exeter Medical School, Exeter, UK.
  • Bewshea CM; Gastroenterology, Royal Devon and Exeter Hospital, Exeter, UK.
  • Hart JW; Exeter IBD Pharmacogenetics, University of Exeter Medical School, Exeter, UK.
  • Russell RK; Gastroenterology, Royal Devon and Exeter Hospital, Exeter, UK.
  • Ahmad T; Gastroenterology, Royal Devon and Exeter Hospital, Exeter, UK.
  • Goodhand JR; Biochemistry, Royal Devon and Exeter Hospital, Exeter, UK.
  • Kennedy NA; The College of Medicine & Health, University of Exeter, Exeter, UK.
Arch Dis Child ; 105(10): 957-963, 2020 10.
Article em En | MEDLINE | ID: mdl-32424002
OBJECTIVE: To determine the diagnostic accuracy of calprotectin to diagnose inflammatory bowel disease (IBD) in children in whom general practitioners (GPs) suspected IBD. DESIGN: Prospective observational cohort study of a new calprotectin-based primary care referral pathway. SETTING: 48 GP practices and gastroenterology secondary care services at the Royal Devon and Exeter NHS Foundation Trust in the South-West of England, UK. PATIENTS: 195 children aged between 4 and 18 years referred on the pathway between January 2014 and August 2017 for investigation of gastrointestinal symptoms were included. INTERVENTIONS: Primary-care-driven faecal calprotectin testing. Primary and secondary care records over 12 months from the point of calprotectin testing were used as the reference standard. MAIN OUTCOME MEASURES: Diagnostic accuracy of calprotectin testing to detect IBD. RESULTS: 7% (13/195) tested patients were diagnosed with IBD. Using our prespecified cut-off of 100 µg/g, calprotectin had a diagnostic accuracy of 91% (95% CI 86% to 95%) with a sensitivity for distinguishing IBD from non-IBD of 100% (95% CI 75% to 100%), a specificity of 91% (95% CI 85% to 94%), a positive predictive value of 43% (95% CI 25% to 63%) and a negative predictive value of 100% (95% CI 98% to 100%). Calprotectin testing had no effect on the time to diagnosis, but a negative test contributed to saved referrals and was associated with fewer diagnostic tests in secondary care. CONCLUSIONS: Calprotectin testing of children with suspected IBD in primary care accurately distinguishes IBD from a functional gut disorder, reduces secondary care referrals and associated diagnostic healthcare utilisation.
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Texto completo: 1 Base de dados: MEDLINE Assunto principal: Doenças Inflamatórias Intestinais / Complexo Antígeno L1 Leucocitário / Fezes Limite: Adolescent / Child / Child, preschool / Female / Humans / Male Idioma: En Ano de publicação: 2020 Tipo de documento: Article

Texto completo: 1 Base de dados: MEDLINE Assunto principal: Doenças Inflamatórias Intestinais / Complexo Antígeno L1 Leucocitário / Fezes Limite: Adolescent / Child / Child, preschool / Female / Humans / Male Idioma: En Ano de publicação: 2020 Tipo de documento: Article