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An audit on the appropriate use of faecal calprotectin testing within the Taranaki DHB: a case for a more discerning
1Medicine, Taranaki Base Hospital. Sean.Lance@tdhb.org.nz.
Aims:
Faecal calprotectin (FC) is a recognised marker for excluding inflammatory bowel disease (IBD). However, it is often not used appropriately. This audit aimed to identify the rate of its use of in Taranaki, along with attempting to assess how appropriately it is used and overall utility.
Methods:
A list of FCs performed in Taranaki from July 2013 to December 2013 was obtained. Notes were examined, identifying the indication, its outcome, and a decision made whether or not the test added any benefit.
Results:
206 patients were identified. A large number (n=75) were excluded due to inadequate clinical information. Of the remaining 131 patients, 37% (n=49) did not benefit. 22% (n=29) avoided further investigation with a negative result. 91% of patients with previously known IBD avoided invasive investigation with a negative result. There was a strong correlation between very high levels (>500 mg/g) and a diagnosis of IBD (88%), as well as a strong correlation between lower levels (<200mg/g) and excluding IBD (86%).
Conclusions:
FC remains useful to exclude IBD, and can assist in patients with established disease. However, in a significant percentage, the test adds no value. The absolute level of FC may also assist diagnosis. More research is needed, and more education is recommended.