PTH-092 Clinical validity and utility of faecal calprotectin in primary care

Introduction Faecal Calprotectin (FC) is recommended in primary care (1°care) to help differentiate inflammatory bowel disease (IBD) from irritable bowel syndrome (IBS), although data to justify this practice are limited. 1,2 In 2014 we introduced FC to 1°care and in parallel conducted a large prospective observational study to assess the clinical validity and utility of FC in this setting, and develop an integrated decision tool. Method GPs from 57 local practices were recommended to submit an FC test for patients with suspected or possible IBD. Criteria for testing included age Results 1143 FC tests were submitted (Jan’14-Mar’16), with 761 used in this interim analysis. 458 (59%) were female and median age was 30 years. 50 (7%) patients were diagnosed with IBD, one (0.2%) with an adenoma ≥1 cm and none with CRC. FC≥100 µg/g had a sensitivity=0.92, specificity=0.75, PPV=0.21, NPV=0.99 (AUROC=0.83 [95%CI 0.79–0.87]) for IBD. False negative FC tests occurred in 4 patients later diagnosed with IBD. Red-flag symptoms were reported in 411 (54%) of all patients, 194 (47%) of whom were not referred to 2°care. FC was negative in 520 (68%), and yet 169 (33%) of this group were sill referred to GI services. Multivariable logistic regression demonstrated FC (log 10 FC=OR 48.2, p 2 0.50). Based on pre-test referral intentions FC saved 252 referrals. The median time from GP referral to IBD diagnosis was 45 days (IQR 25–98). Conclusion FC is a sensitive and specific test in the primary care setting to distinguish IBD from IBS. It reduces referrals and subsequent endoscopic investigations in patients References . Waugh N, et al . doi:10.3310/hta17550(2013) . NICE DG11 (2013). Disclosure of Interest None Declared