Related Experiment Video
Updated: Oct 27, 2025
E-Patient Counseling Trial E-PACO: Computer Based Education versus Nurse Counseling for Patients to Prepare for Colonoscopy
Published on: August 1, 2019
Effect of faecal calprotectin testing on referrals for children with chronic gastrointestinal symptoms in primary
Sophie Ansems1, Marjolein Berger2, Patrick van Rheenen3
1General Practice and Elderly Care Medicine, University Medical Centre Groningen, Groningen, The Netherlands s.m.ansems@umcg.nl.
Insights
Point-of-care testing for faecal calprotectin (FCal-POCT) in primary care may reduce referrals for children with chronic gastrointestinal symptoms. This strategy helps differentiate functional gastrointestinal disorders from organic conditions, improving care pathways.
Area of Science:
- Pediatric Gastroenterology
- Primary Care Medicine
- Diagnostic Test Evaluation
Background:
- General practitioners (GPs) face challenges differentiating functional gastrointestinal disorders (FGID) from organic conditions in children.
- Chronic gastrointestinal symptoms in children often lead to specialist referrals, impacting healthcare resources.
Purpose of the Study:
- To evaluate if point-of-care testing (POCT) for faecal calprotectin (FCal) can decrease referral rates to pediatric specialist care for children with chronic gastrointestinal symptoms.
- To assess the impact of an FCal-POCT strategy on parental satisfaction, symptom burden, and quality of life.
Main Methods:
- A pragmatic cluster randomized controlled trial involving general practices.
- Intervention group GPs will use FCal-POCT after training; control group follows standard Dutch guidelines.
- Children aged 4-18 with chronic diarrhoea or recurrent abdominal pain will be included. Primary outcome is the referral rate within 6 months.
Main Results:
- The primary outcome is the rate of referral to pediatric specialist care within 6 months post-assessment.
- Secondary outcomes include parental satisfaction, symptom severity, quality of life, and healthcare costs.
- Sample size calculation requires 158 GP practices to recruit 406 children.
Conclusions:
- Findings will inform recommendations on FCal use in primary care for pediatric patients.
- Implementing FCal-POCT may optimize diagnostic pathways and reduce unnecessary specialist referrals.
- This study contributes to evidence-based guidelines for managing chronic gastrointestinal symptoms in children.
Introduction:
Children with chronic gastrointestinal symptoms are frequently seen in primary care, yet general practitioners (GPs) often experience challenges distinguishing functional gastrointestinal disorders (FGID) from organic disorders. We, therefore, aim to evaluate whether a test strategy that includes point-of-care testing (POCT) for faecal calprotectin (FCal) can reduce the referral rate to paediatric specialist care among children with chronic gastrointestinal symptoms. The study findings will contribute to improving the recommendations on FCal use among children in primary care.
Methods And Analysis:
In this pragmatic cluster randomised controlled trial, we will randomise general practices into intervention and control groups. The intervention group will use FCal-POCT when indicated, after completing online training about its indication, interpretation and follow-up as well as communicating an FGID diagnosis. The control group will test and treat according to Dutch GP guidelines, which advise against FCal testing in children. GPs will include children aged 4-18 years presenting to primary care with chronic diarrhoea and/or recurrent abdominal pain. The primary outcome will be the referral rate for children with chronic gastrointestinal symptoms within 6 months after the initial assessment. Secondary outcomes will be evaluated by questionnaires completed at baseline and at 3- and 6-month follow-up. These outcomes will include parental satisfaction and concerns, gastrointestinal symptoms, impact of symptoms on daily function, quality of life, proportion of children with paediatrician-diagnosed FGID referred to secondary care, health service use and healthcare costs. A sample size calculation indicates that we need to recruit 158 GP practices to recruit 406 children.
Ethics And Dissemination:
The Medical Research Ethics Committee (MREC) of the University Medical Center Groningen (The Netherlands) approved this study (MREC number: 201900309). The study results will be made available to patients, GPs, paediatricians and laboratories via peer-reviewed publications and in presentations at (inter)national conferences.
Trial Registration Number:
The Netherlands Trial Register: NL7690 (Pre-results).
More Related Videos
07:06Fecal Microbiota Transplantation via Colonoscopy for Recurrent C. difficile Infection
Published on: December 8, 2014
05:56Implementation of Non-invasive Point of Care Transient Elastography for Evaluation of Liver Disease in Pediatric Populations with Cystic Fibrosis
Published on: August 29, 2025
Related Concept Videos
01:30Serum Laboratory Studies, Stool Test, Breath Test
01:30Inflammatory Bowel Disease III: Diagnostic Studies and Management I-Nutritional Therapy
Diagnostic studies
A colonoscopy is the definitive screening test, distinguishing ulcerative colitis from other colon diseases with similar symptoms. During a colonoscopy test, inflamed mucosa with exudate ulcerations can be observed, and biopsies are taken to determine the histologic characteristics of the...