Daily Archives: 23/01/2021

Is FIT fit for purpose? Yes.

Re. Restoring Cancer Services (posted 18/1/2021). This may be of interest – from the British Journal Of Cancer 19th Jan 2021 – Don

Diagnostic Performance of a faecal immunochemical test for patients with low-risk symptoms of colorectal cancer in primary care: an evaluation in the South West of England.

Background: The faecal immunochemical test (FIT) was introduced to triage patients with low-risk symptoms of possible colorectal cancer in English primary care in 2017, underpinned by little primary care evidence.

Methods: All healthcare providers in the South West of England (population 4 million) participated in this evaluation. 3890 patients aged ≥50 years presenting in primary care with low-risk symptoms of colorectal cancer had a FIT from 01/06/2018 to 31/12/2018. A threshold of 10 μg Hb/g faeces defined a positive test.

Results: Six hundred and eighteen (15.9%) patients tested positive; 458 (74.1%) had an urgent referral to specialist lower gastrointestinal (GI) services within three months. Forty-three were diagnosed with colorectal cancer within 12 months. 3272 tested negative; 324 (9.9%) had an urgent referral within three months. Eight were diagnosed with colorectal cancer within 12 months. Positive predictive value was 7.0% (95% CI 5.1–9.3%). Negative predictive value was 99.8% (CI 99.5–99.9%). Sensitivity was 84.3% (CI 71.4–93.0%), specificity 85.0% (CI 83.8–86.1%). The area under the ROC curve was 0.92 (CI 0.86–0.96). A threshold of 37 μg Hb/g faeces would identify patients with an individual 3% risk of cancer.

Conclusions: FIT performs exceptionally well to triage patients with low-risk symptoms of colorectal cancer in primary care; a higher threshold may be appropriate in the wake of the COVID-19 crisis

Click here for the full article

Ed – Thanks to Don for sending this in.

Self-Management and the “app”

Electronic devices for home use which measure physical health parameters such as blood pressure, heart rate, blood oxygen levels and activity etc. proliferate. Results from them may be shared, usually as a part of a treatment programme, with a doctor, nurse or pharmacist. However, what is not being regularly monitored is the patient’s general health and well-being. IT companies have been encouraged to develop software to allow  patients to record and display this at home, using a mobile programme or app – one such is Vinehealth.

It would be good if C-Side members, could evaluate this, since there is no doubt that programmes such as this will become commonplace in the not too distant future.

You can learn more about Vinehealth here (or click on the picture). You can download the app from the App Store (Apple) and Google Play, It is free to download and use and is unlikely to present any risk to confidential information. Remember it is a mobile app, designed for use on a phone (IOS or Android) or an iPad; not at present on a laptop or similar.