The utilization of fecal occult blood testing in the institutionalized elderly

S. E. Klos, P. Drinka, James Goodwin

Research output: Contribution to journalArticle

10 Citations (Scopus)

Abstract

Objective: To examine physician use of stool guaiac testing in order to determine indications for testing, how the test was used, and the consequences of a particular test result. Design: Retrospective case series. Setting: Large midwestern inpatient nursing home facility. Patients: All patients with positive fecal occult blood tests (FOBT) and one-third of patients with negative FOBT. Results: In an 18-month period, 916 occult blood tests were performed on 339 patients (37% of the nursing home census). Patients over age 90 were as likely to receive FOBT as those under age 70. Fourteen percent of those tested had at least one positive test. Fifty-eight percent of the patients with positive tests underwent no additional diagnostic testing. No cause for the positive FOBT was found for 68% of patients receiving the test for routine screening. Physician estimates of how frequently they employed FOBT for these patients correlated very poorly with their actual practices (r = .17). Conclusion: There is a high prevalence of positive results from FOBT among nursing home patients. In most cases, such results do not cause a change of therapy or result in additional workup. Lack of information on the role of FOBT in nursing home patients contributes to the great diversity in utilization of this test by nursing home physicians.

Original languageEnglish (US)
Pages (from-to)1169-1173
Number of pages5
JournalJournal of the American Geriatrics Society
Volume39
Issue number12
StatePublished - 1991
Externally publishedYes

Fingerprint

Occult Blood
Hematologic Tests
Nursing Homes
Physicians
Guaiac
Censuses
Inpatients

ASJC Scopus subject areas

  • Geriatrics and Gerontology

Cite this

The utilization of fecal occult blood testing in the institutionalized elderly. / Klos, S. E.; Drinka, P.; Goodwin, James.

In: Journal of the American Geriatrics Society, Vol. 39, No. 12, 1991, p. 1169-1173.

Research output: Contribution to journalArticle

@article{d5e5d052d92a49d58bab30084c460a40,
title = "The utilization of fecal occult blood testing in the institutionalized elderly",
abstract = "Objective: To examine physician use of stool guaiac testing in order to determine indications for testing, how the test was used, and the consequences of a particular test result. Design: Retrospective case series. Setting: Large midwestern inpatient nursing home facility. Patients: All patients with positive fecal occult blood tests (FOBT) and one-third of patients with negative FOBT. Results: In an 18-month period, 916 occult blood tests were performed on 339 patients (37{\%} of the nursing home census). Patients over age 90 were as likely to receive FOBT as those under age 70. Fourteen percent of those tested had at least one positive test. Fifty-eight percent of the patients with positive tests underwent no additional diagnostic testing. No cause for the positive FOBT was found for 68{\%} of patients receiving the test for routine screening. Physician estimates of how frequently they employed FOBT for these patients correlated very poorly with their actual practices (r = .17). Conclusion: There is a high prevalence of positive results from FOBT among nursing home patients. In most cases, such results do not cause a change of therapy or result in additional workup. Lack of information on the role of FOBT in nursing home patients contributes to the great diversity in utilization of this test by nursing home physicians.",
author = "Klos, {S. E.} and P. Drinka and James Goodwin",
year = "1991",
language = "English (US)",
volume = "39",
pages = "1169--1173",
journal = "Journal of the American Geriatrics Society",
issn = "0002-8614",
publisher = "Wiley-Blackwell",
number = "12",

}

TY - JOUR

T1 - The utilization of fecal occult blood testing in the institutionalized elderly

AU - Klos, S. E.

AU - Drinka, P.

AU - Goodwin, James

PY - 1991

Y1 - 1991

N2 - Objective: To examine physician use of stool guaiac testing in order to determine indications for testing, how the test was used, and the consequences of a particular test result. Design: Retrospective case series. Setting: Large midwestern inpatient nursing home facility. Patients: All patients with positive fecal occult blood tests (FOBT) and one-third of patients with negative FOBT. Results: In an 18-month period, 916 occult blood tests were performed on 339 patients (37% of the nursing home census). Patients over age 90 were as likely to receive FOBT as those under age 70. Fourteen percent of those tested had at least one positive test. Fifty-eight percent of the patients with positive tests underwent no additional diagnostic testing. No cause for the positive FOBT was found for 68% of patients receiving the test for routine screening. Physician estimates of how frequently they employed FOBT for these patients correlated very poorly with their actual practices (r = .17). Conclusion: There is a high prevalence of positive results from FOBT among nursing home patients. In most cases, such results do not cause a change of therapy or result in additional workup. Lack of information on the role of FOBT in nursing home patients contributes to the great diversity in utilization of this test by nursing home physicians.

AB - Objective: To examine physician use of stool guaiac testing in order to determine indications for testing, how the test was used, and the consequences of a particular test result. Design: Retrospective case series. Setting: Large midwestern inpatient nursing home facility. Patients: All patients with positive fecal occult blood tests (FOBT) and one-third of patients with negative FOBT. Results: In an 18-month period, 916 occult blood tests were performed on 339 patients (37% of the nursing home census). Patients over age 90 were as likely to receive FOBT as those under age 70. Fourteen percent of those tested had at least one positive test. Fifty-eight percent of the patients with positive tests underwent no additional diagnostic testing. No cause for the positive FOBT was found for 68% of patients receiving the test for routine screening. Physician estimates of how frequently they employed FOBT for these patients correlated very poorly with their actual practices (r = .17). Conclusion: There is a high prevalence of positive results from FOBT among nursing home patients. In most cases, such results do not cause a change of therapy or result in additional workup. Lack of information on the role of FOBT in nursing home patients contributes to the great diversity in utilization of this test by nursing home physicians.

UR - http://www.scopus.com/inward/record.url?scp=0025787735&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=0025787735&partnerID=8YFLogxK

M3 - Article

C2 - 1960360

AN - SCOPUS:0025787735

VL - 39

SP - 1169

EP - 1173

JO - Journal of the American Geriatrics Society

JF - Journal of the American Geriatrics Society

SN - 0002-8614

IS - 12

ER -