ArticleBMJ open2021
Test accuracy of faecal calprotectin for inflammatory bowel disease in UK primary care: a retrospective cohort study of the IMRD-UK data.
Article in BMJ open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 11 papers, 3 of them syntheses that pooled it.
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Who cites it
11 citing papers in PubMed, 3 syntheses or guidelines pooled it, 20 citations in OpenAlex.
- Early diagnosis of Crohn's disease in patients presenting with a perianal fistula: systematic review and development of a perianal red flags index.Techniques in coloproctology · 2025Pooled it
- Frequency of irritable bowel syndrome in spondyloarthritis: a multicentric cross-sectional study and meta-analysis.RMD open · 2024Pooled it
- Comparing outcomes from tailored meta-analysis with outcomes from a setting specific test accuracy study using routine data of faecal calprotectin testing for inflammatory bowel disease.BMC medical research methodology · 2022Pooled it
- Fecal Arachidonic Acid: A Potential Biomarker for Inflammatory Bowel Disease Severity.International journal of molecular sciences · 2025Article
- High-throughput, pan-leukocyte biomarkers for the detection of inflammation in human breastmilk and stool.Frontiers in epigenetics and epigenomics · 2025Article
- Fecal Nervonic Acid as a Biomarker for Diagnosing and Monitoring Inflammatory Bowel Disease.Biomedicines · 2024Article
- Faecal calprotectin in primary care: is its current use supported by the evidence?The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Review
- Fecal short chain fatty acids and urinary 3-indoxyl sulfate do not discriminate between patients with Crohn´s disease and ulcerative colitis and are not of diagnostic utility for predicting disease severity.Lipids in health and disease · 2023Article
- Diagnostic value of fecal calprotectin in primary care patients with gastrointestinal symptoms: A retrospective Swedish cohort study.JGH open : an open access journal of gastroenterology and hepatology · 2023Article
- Natriuretic peptide testing and heart failure diagnosis in primary care: diagnostic accuracy study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2023Article
- Faecal calprotectin testing in UK general practice: a retrospective cohort study using The Health Improvement Network database.The British journal of general practice : the journal of the Royal College of General Practitioners · 2021Article
Corrections and comments
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Authors and funding
5 authors at 2 institutions in 1 country.
Funding
Abstract
objectiveTo estimate the test accuracy of faecal calprotectin (FC) for inflammatory bowel disease (IBD) in the primary care setting using routine electronic health records.
designRetrospective cohort test accuracy study.
settingUK primary care.
participants5970 patients (≥18 years) without a previous IBD diagnosis and with a first FC test between 1 January 2006 and 31 December 2016. We excluded multiple tests and tests without numeric results in units of µg/g.
interventionFC testing for the diagnosis of IBD. Disease status was confirmed by a recorded diagnostic code and/or a drug code of an IBD-specific medication at three time points after the FC test date.
main outcome measuresSensitivity, specificity, and positive and negative predictive values for the differential of IBD versus non-IBD and IBD versus irritable bowel syndrome (IBS) at the 50 and 100 µg/g thresholds.
results5970 patients met the inclusion criteria and had at least 6 months of follow-up data after FC testing. 1897 had an IBS diagnosis, 208 had an IBD diagnosis, 31 had a colorectal cancer diagnosis, 80 had more than one diagnosis and 3754 had no subsequent diagnosis. Sensitivity, specificity, and positive and negative predictive values were 92.9% (88.6% to 95.6%), 61.5% (60.2% to 62.7%), 8.1% (7.1% to 9.2%) and 99.6% (99.3% to 99.7%), respectively, at the threshold of 50 µg/g. Raising the threshold to 100 µg/g missed less than 7% additional IBD cases. Longer follow-up had no effect on test accuracy. Overall, uncertainty was greater for specificity than sensitivity. General practitioners' (GPs') referral decisions did not follow the anticipated clinical pathways in national guidance.
conclusionsGPs can be confident in excluding IBD on the basis of a negative FC test in a population with low pretest risk but should interpret a positive test with caution. The applicability of national guidance to general practice needs to be improved.
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