Can the CalproQuest predict a positive Calprotectin test? A prospective diagnostic study


Autoři: Corinne Chmiel aff001;  Oliver Senn aff001;  Susann Hasler aff001;  Thomas Rosemann aff001;  Gerhard Rogler aff002;  Nadine Zahnd aff003;  Ryan Tandjung aff001;  Nathalie Scherz aff001;  Michael Christian Sulz aff004;  Stephan Vavricka aff002
Působiště autorů: Institute of Primary Care, University and University Hospital of Zurich, Switzerland aff001;  Department of Gastroenterology and Hepatology, University Hospital Zurich, Switzerland aff002;  IBDnet, Swiss Research and Communication Network on Inflammatory Bowel Disease, Zurich, Switzerland aff003;  Division of Gastroenterology and Hepatology, Cantonal Hospital Sanct Gallen, Switzerland aff004
Vyšlo v časopise: PLoS ONE 14(11)
Kategorie: Research Article
doi: 10.1371/journal.pone.0224961

Souhrn

Background

Diagnosis of inflammatory bowel disease (IBD) in primary care (PC) is challenging and associated with a considerable diagnostic delay. Using a calprotectin test for any PC patient with abdominal complaints would cause significant costs. The 8-item-questionnaire CalproQuest was developed to increase the pre-test probability for a positive Calprotectin. It is a feasible instrument to assess IBD in PC, but has not yet been evaluated in clinical routine. This study, therefore, aimed to validate whether the CalproQuest increases pretest-probability for a positive fecal Calprotectin.

Methods

Prospective diagnostic trial. The CalproQuest consists of 4 major and 4 minor questions suggestive for IBD. It is considered positive if ≥ 2 major or 1 major and 2 minor criteria are positive. Primary outcome: Sensitivity and specificity of the CalproQuest for Calprotectin levels ≥ 50 μg/g and for positive IBD diagnosis among patients referred to endoscopic evaluation at secondary care level. Secondary finding: Patient-reported diagnostic delay.

Results

156 patients from 7 study centers had a complete CalproQuest and fecal Calprotectin test. The sensitivity and specificity of CalproQuest for Calprotectin ≥ 50 μg/g was 36% and 57%. The sensitivity and specificity of the CalproQuest for positive IBD diagnosis was 37% and 67%. The diagnostic delay was 61 months (SD 125.2).

Conclusion

In this prospective diagnostic study, the sensitivity and specificity of CalproQuest for Calprotectin levels ≥ 50 μg/g and positive IBD diagnosis were poor. Additional prospective studies concerning the ideal cut-off values, validity and cost-effectiveness of a combined use with the Calprotectin test in the PC setting are necessary.

Klíčová slova:

Colitis – Crohn's disease – Diagnostic medicine – Endoscopy – Inflammatory bowel disease – Physicians – Primary care – Ulcerative colitis


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