Development and validation of a faecal immunochemical test-based model in the work-up of patients with iron deficiency anaemia.

Autor:	Hernández G; Servicio de Aparato Digestivo, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain., Quintero E; Servicio de Aparato Digestivo, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain.; Departamento de Medicina Interna, Instituto Universitario de Tecnologías Biomédicas (ITB) & Centro de Investigación Biomédica de Canarias (CIBICAN), Universidad de La Laguna, San Cristóbal de La Laguna, Spain., Morales-Arraez D; Servicio de Aparato Digestivo, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain., García Rayado G; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain., Hijos-Mallada G; Hospital Clínico Universitario Lozano Blesa, Zaragoza, Spain., Fernández-Fernández N; Hospital Álvaro Cunqueiro de Vigo, Pontevedra, Spain., de Castro-Parga L; Complejo Hospitalario Universitario de Vigo, Vigo, Spain., Álvarez-Sánchez MV; Complejo Hospitalario Universitario de Pontevedra, Pontevedra, Spain., Olano C; Clínica de Gastroenterología. Facultad de Medicina, Montevideo, Uruguay., Rodríguez-Alcalde D; Hospital Universitario de Móstoles, Madrid, Spain., Amaral-González C; Servicio de Aparato Digestivo, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain., Alonso-Abreu I; Servicio de Aparato Digestivo, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain., Nicolás-Pérez D; Servicio de Aparato Digestivo, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain., Carrillo-Palau M; Servicio de Aparato Digestivo, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain., González-Dávila E; Departamento de Matemáticas, Estadística e Investigación Operativa, Instituto IMAULL, Universidad de La Laguna, San Cristóbal de La Laguna, Spain., Gimeno-García AZ; Servicio de Aparato Digestivo, Hospital Universitario de Canarias, Santa Cruz de Tenerife, Spain.
Jazyk:	angličtina
Zdroj:	Frontiers in medicine [Front Med (Lausanne)] 2024 Jun 25; Vol. 11, pp. 1407812. Date of Electronic Publication: 2024 Jun 25 (Print Publication: 2024).
DOI:	10.3389/fmed.2024.1407812
Abstrakt:	Objective: In patients with iron deficiency anaemia (IDA), the diagnostic yield of gastroscopy and colonoscopy (bidirectional endoscopy) in detecting neoplastic lesions is low. This study aimed to develop and validate a faecal immunochemical test (FIT)-based model to optimise the work-up of patients with IDA. Methods: Outpatients with IDA were enrolled in a prospective, multicentre study from April 2016 to October 2019. One FIT was performed before bidirectional endoscopy. Significant gastrointestinal lesions were recorded and a combined model developed with variables that were independently associated with significant colorectal lesions in the multivariate analysis. The model cut-off was selected to provide a sensitivity of at least 95% for colorectal cancer (CRC) detection, and its performance was compared to different FIT cut-offs. The data set was randomly split into two groups (developed and validation cohorts). An online calculator was developed for clinical application. Results: The development and validation cohorts included 373 and 160 patients, respectively. The developed model included FIT value, age, and sex. In the development and validation cohorts, a model cut-off of 0.1375 provided a negative predictive value of 98.1 and 96.7% for CRC and 90.7 and 88.3% for significant colorectal lesions, respectively. This combined model reduced the rate of missed significant colorectal lesions compared to FIT alone and could have avoided more than one-fourth of colonoscopies. Conclusion: The FIT-based combined model developed in this study may serve as a useful diagnostic tool to triage IDA patients for early endoscopic referral, resulting in considerable reduction of unnecessary colonoscopies. Competing Interests: The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest. (Copyright © 2024 Hernández, Quintero, Morales-Arraez, Rayado, Hijos-Mallada, Fernández, Castro-Parga, Álvarez-Sánchez, Olano, Rodríguez-Alcalde, Amaral-González, Alonso-Abreu, Nicolás-Pérez, Carrillo-Palau, González-Dávila and Gimeno-García.)
Databáze:	MEDLINE
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