在下胃肠道诊断途径内拒绝便免疫化学测试:一个队列研究
Alex J Ball1, Imran Aziz1,2, Ravishankar B Sargur3
1Department of Gastroenterology, Sheffield Teaching Hospitals NHS Foundation Trust, Sheffield, South Yorkshire, UK.
Journal of primary care & community health
|February 13, 2024
概括
对于结直肠癌查的便免疫化学测试 (FIT) 排斥率在三年内从17.4%降至1.3%. 抽样错误是主要原因,但改进表明干预措施可以进一步减少FIT样本拒绝.
科学领域:
- 胃肠病学 胃肠病学
- 在瘤学瘤学.
- 临床诊断 临床诊断 临床诊断
背景情况:
- 便免疫化学测试 (FIT) 对于分类患有结直肠癌 (CRC) 风险的初级保健患者至关重要.
- 提高FIT样本的回报率和准确性是提高CRC查效率的一个重点.
- 对于提交实验室分析的FIT样本的准确填写和随后的拒绝率存在不确定性.
研究的目的:
- 为了确定从初级保健患者返回的FIT样本的排斥率.
- 确定FIT样本拒绝的主要原因.
- 分析FIT样本拒绝率的趋势随着时间的推移.
主要方法:
- 2019年9月至2022年12月期间在中央实验室处理的FIT样本的回顾性审查.
- 分析了来自225家全科医院的当地数据,为大约200万人提供服务.
- 查询记录的拒绝原因,以确定共同的主题和计算拒绝率.
主要成果:
- 总共收到126,422个FIT标本,其中5190个 (4.1%) 被拒绝.
- 观察到每月拒绝率的显著下降,从2019年9月的17.4%降至2022年12月的1.3% (P < .001).
- 采样错误是最常见的拒绝原因 (2151/5190),其次是过期的标本,缺失的采集日期/时间以及不完整或不可阅读的文档.
结论:
- 这项研究首次报告了症状初级保健患者的FIT排斥率,显示了随着时间的推移显著改善.
- 有针对性的干预措施已经成功降低了FIT样本拒绝率.
- 进一步的干预措施有可能减少国家卫生服务资源的使用,降低成本,并尽量减少结直肠癌的诊断延迟.
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