TITLE

Preoperative Testing for Fecal Occult Blood: A Questionable Practice

AUTHOR(S)
Sonnenberg, Amnon; Townsend, William F.
PUB. DATE
October 1992
SOURCE
American Journal of Gastroenterology;Oct1992, Vol. 87 Issue 10, p1410
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
The benefit of fecal occult blood testing (FOBT) in patients without gastrointestinal symptoms who are hospitalized for an elective surgical procedure is uncertain. To resolve this issue, we analyzed the costs and benefits of preoperative FOBT by the model of a decision tree. In 2- and 3-way sensitivity analyses, the costs of diagnostic and therapeutic procedures and the probabilities of their various outcomes are varied simultaneously so that we might study their joint influence on the outcome of the decision analysis. The decision analysis shows that preoperative FOBT is associated with a smaller benefit than would be its omission. The higher cost and lower net benefit of preoperative FOBT reflect the impact of false-positive tests for occult blood. False-positive FOBT leads to expenditures for negative gastrointestinal work-ups. increased procedural costs, and a diminished rate of success for the elective surgical procedure, by delaying it. This outcome of the analysis is insensitive to large variations in the costs and probabilities built into the model. We conclude that screening for fecal occult blood provides no benefit if done routinely in patients who are hospitalized for any major surgical procedure.
ACCESSION #
16067720

 

Related Articles

  • Comment on bidirectional endoscopy in patients with fecal occult blood. Giordano, P.; Huang, A. // Surgical Endoscopy;Jan2003, Vol. 17 Issue 1, p171 

    Comments on the article "Bidirectional endoscopy in patients with fecal occult blood: Redefining the bleeding sites," by J. P. Velez et al. in the 2002 issue. Role of combined upper and lower gastrointestinal (GI) endoscopy in patients with a positive fecal occult blood test; Failure of the...

  • Fecal Occult Blood Screening in Children with Severe Malnutrition. Jain, Sarika; Das, Shukla; Gupta, Piyush // Indian Pediatrics;Dec2007, Vol. 44 Issue 12, p913 

    We screened 50 consecutive severely malnourished children for evidence of gastrointestinal tract blood loss. Malnutrition was graded as per WHO recommendations. Gastrointestinal blood loss was detected using fecal occult blood test (FOBT) kit. Thirty (60%) of the study population were documented...

  • 82270, 82272, G0107: Ease Your Hemoccult Test Coding With This Advice.  // Gastroenterology Coding Alert;Nov2010, Vol. 12 Issue 11, p81 

    The article offers tips on how to properly code the fecal occult blood test (FOBT). It emphasizes the importance of understanding the different purposes of the three hemoccult codes, 82270, 82272 and G0107. It also suggests that the reason why the gastroenterologist has ordered the FOBT to...

  • Use of HemoQuant Assays to Assess the Effect of Oral Iron Preparations on Stool Hemoccult Tests. Coles, Edward F.; Starnes, Eddie C. // American Journal of Gastroenterology;Oct1991, Vol. 86 Issue 10, p1442 

    To determine whether oral iron preparations taken in therapeutic doses are capable of causing either true-positive, false-positive, or false-negative fecal occult blood Hemoccult tests, a prospective, before/after trial was conducted in the gastroenterology clinic of an Army medical center....

  • FECAL ANALYSIS  // Davis's Comprehensive Handbook of Laboratory & Diagnostic Tests ;Jan2006, p634 

    Feces consist mainly of cellulose and other undigested foodstuffs, bacteria, and water. Other substances normally found in feces include epithelial cells shed from the gastrointestinal (GI) tract, small amounts of fats, bile pigments in the form of urobilinogen, GI and pancreatic secretions,...

  • Do FOBT trump other colorectal cancer screening options?  // PharmacoEconomics & Outcomes News;10/30/2010, Issue 615, p7 

    The article discusses research on the cost-effectiveness of stool DNA testing and fecal occult blood test (FOBT) in screening colorectal cancer, which references the study "Stool DNA Testing to Screen for Colorectal Cancer in the Medicare Population: A Cost-Effectiveness Analysis," by I....

  • The author replies. Schwesinger, W.H.; Velez, J.P.; Stauffer, J.; Gaskill, H.V.; Kazantsev, G.B.; Sirinek, K.R.; Strodel, W.E. // Surgical Endoscopy;Jan2003, Vol. 17 Issue 1, p172 

    Presents a letter to the editor to respond to the comment by P. Giordano and A. Huang on the article about the use of bidirectional endoscopy on patients with fecal occult blood.

  • COLON POLYPS AND CANCER IN 1994. Carey, W. D.; Achkar, E. // American Journal of Gastroenterology;Jun1994, Vol. 89 Issue 6, p823 

    Discusses the condition of the colon polyps and cancer epidemic in the U.S. in 1994. Prevalence rate of colon neoplastic polyps in the country; Efforts by the gastroenterology community to promote cancer screening of the population at risk for colon cancer; Cost of the implementation of stool...

  • Does Fecal Occult Blood Testing Really Reduce Mortality? A Reanalysis of Systematic Review Data. Moayyedi, Paul; Achkar, Edgar // American Journal of Gastroenterology;Feb2006, Vol. 101 Issue 2, p380 

    INTRODUCTION: Colorectal cancer (CRC) is a common cause of cancer mortality. A variety of CRC screening strategies are being adopted in many developed countries. Fecal occult blood testing (FOBT) is one option for screening that has the most evidence for efficacy and is also the cheapest...

Share

Read the Article

Courtesy of THE LIBRARY OF VIRGINIA

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics