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Table 4 Risk of SCD in relation to routine diagnostic predictors and faecal biomarkers as based on the optimism-corrected combined POC and the POC FIT extended diagnostic models, developed in 810 Dutch primary care patients with lower abdominal complaints referred for endoscopy in the CEDAR studya,b

From: Is there an added value of faecal calprotectin and haemoglobin in the diagnostic work-up for primary care patients suspected of significant colorectal disease? A cross-sectional diagnostic study

Ā 

Calprotectin POC and POC FIT extended model

POC FIT extended model

Diagnostic predictor

Regression coefficient (SE)

OR (95Ā % CI)

Wald P value

Regression coefficient (SE)

OR (95Ā % CI)

Wald P value

Patient history

ā€ƒAge, per 5Ā years

0.11 (0.05)

1.1 (1.0ā€“1.2)

0.024

0.12 (0.05)

1.1 (1.0ā€“1.2)

0.008

ā€ƒAbdominal pain

ā€“0.20 (0.27)

0.8 (0.5ā€“1.4)

0.45

ā€“0.22 (0.27)

0.8 (0.5ā€“1.3)

0.4

ā€ƒRectal blood loss

0.75 (0.25)

2.1 (1.3ā€“3.4)

0.003

0.82 (0.25)

2.3 (1.4ā€“3.7)

<0.001

ā€ƒRectal mucus

0.37 (0.24)

1.4 (0.9ā€“2.3)

0.13

0.43 (0.24)

1.5 (1.0ā€“2.4)

0.072

ā€ƒWeight loss

0.27 (0.27)

1.3 (0.8ā€“2.2)

0.33

0.34 (0.27)

1.4 (0.8ā€“2.4)

0.21

ā€ƒChange in bowel habit

0.16 (0.28)

1.2 (0.7ā€“2.0)

0.56

0.21 (0.28)

1.2 (0.7ā€“2.1)

0.46

ā€ƒAbdominal bloating

ā€“0.49 (0.24)

0.6 (0.4ā€“1.0)

0.043

ā€“0.49 (0.24)

0.6 (0.4ā€“1.0)

0.044

ā€ƒConstipation

ā€“0.23 (0.24)

0.8 (0.5ā€“1.3)

0.33

ā€“0.19 (0.24)

0.8 (0.5ā€“1.3)

0.43

Physical examination

ā€ƒAbnormal digital rectal examination

0.43 (0.49)

1.5 (0.6ā€“4.0)

0.39

0.47 (0.47)

1.6 (0.6ā€“4.0)

0.33

Faecal tests

ā€ƒCalprotectin POC test, per 100Ā Ī¼g/g

0.28 (0.11)

1.3 (1.1ā€“1.7)

0.014

ā€“

ā€“

ā€“

ā€ƒPositive POC FIT (>6Ā Ī¼g Hb/gc)

1.75 (0.25)

5.8 (3.5ā€“9.3)

<0.001

1.91 (0.24)

6.7 (4.2ā€“10.7)

<0.001

ā€ƒIntercept

ā€“4.08 (0.72)

Ā Ā 

ā€“4.16 (0.72)

Ā Ā 

ā€ƒAUC (95Ā % CI)

0.818 (0.779ā€“0.857)

0.813 (0.772ā€“0.853)

ā€ƒNagelkerkeā€™s R2, % (95Ā % CI)

30.6 (22.4ā€“39.0)

29.5 (21.2ā€“37.9)

  1. AUC area under the receiver operating characteristic curve; CEDAR Cost-Effectiveness of a Decision rule for Abdominal complaints in primary caRe; CI confidence interval; FIT faecal immunochemical test for haemoglobin; OR odds ratio; POC point-of-care; SCD significant colorectal disease; SE standard error
  2. aAll regression coefficients, odds ratios, AUCs, and Nagelkerkeā€™s R2s are optimism-corrected by 500-fold bootstrap resampling. Confidence intervals and Wald tests are based on optimism-corrected parameter estimates and assuming the same SE applies as before optimism-correction
  3. bThese models can be used to calculate the probability for a certain patient of having SCD. For example, according to the POC FIT extended model, a 60-year-old male patient with weight loss and a positive POC FIT has a 1/(1ā€‰+ā€‰exp(ā€“1ā€‰Ć—ā€‰(ā€“4.16ā€‰+ā€‰(0.12ā€‰Ć—ā€‰60/5) ā€“ (0.22ā€‰Ć—ā€‰0)ā€‰+ā€‰(0.82ā€‰Ć—ā€‰0)ā€‰+ā€‰(0.43ā€‰Ć—ā€‰0)ā€‰+ā€‰(0.34ā€‰Ć—ā€‰1)ā€‰+ā€‰(0.21ā€‰Ć—ā€‰0) ā€“ (0.49ā€‰Ć—ā€‰0) ā€“ (0.19ā€‰Ć—ā€‰0)ā€‰+ā€‰(0.47ā€‰Ć—ā€‰0)ā€‰+ā€‰(1.91ā€‰Ć—ā€‰1))))ā€‰=ā€‰38.5Ā % probability of having SCD. Similarly, according to the same model, a 60-year-old female patient with abdominal pain and bloating has a 3.1Ā % probability of having SCD
  4. cLower detection limit as stated by manufacturer