Publication

Can the CalproQuest predict a positive Calprotectin test? A prospective diagnostic study

Journal Paper/Review - Nov 21, 2019

Units
PubMed
Doi
Contact

Citation
Corinne C, Sulz M, Scherz N, Tandjung R, Zahnd N, Rogler G, Rosemann T, Hasler S, Senn O, Vavricka S. Can the CalproQuest predict a positive Calprotectin test? A prospective diagnostic study. PloS one 2019; 14:e0224961.
Type
Journal Paper/Review (English)
Journal
PloS one 2019; 14
Publication Date
Nov 21, 2019
Issn Electronic
1932-6203
Pages
e0224961
Brief description/objective

BACKGROUND
Diagnosis of inflammatory bowel disease (IBD) in primary care (PC) is challenging and associated with a considerable diagnostic delay. Using a calprotectin test for any PC patient with abdominal complaints would cause significant costs. The 8-item-questionnaire CalproQuest was developed to increase the pre-test probability for a positive Calprotectin. It is a feasible instrument to assess IBD in PC, but has not yet been evaluated in clinical routine. This study, therefore, aimed to validate whether the CalproQuest increases pretest-probability for a positive fecal Calprotectin.

METHODS
Prospective diagnostic trial. The CalproQuest consists of 4 major and 4 minor questions suggestive for IBD. It is considered positive if ≥ 2 major or 1 major and 2 minor criteria are positive. Primary outcome: Sensitivity and specificity of the CalproQuest for Calprotectin levels ≥ 50 μg/g and for positive IBD diagnosis among patients referred to endoscopic evaluation at secondary care level. Secondary finding: Patient-reported diagnostic delay.

RESULTS
156 patients from 7 study centers had a complete CalproQuest and fecal Calprotectin test. The sensitivity and specificity of CalproQuest for Calprotectin ≥ 50 μg/g was 36% and 57%. The sensitivity and specificity of the CalproQuest for positive IBD diagnosis was 37% and 67%. The diagnostic delay was 61 months (SD 125.2).

CONCLUSION
In this prospective diagnostic study, the sensitivity and specificity of CalproQuest for Calprotectin levels ≥ 50 μg/g and positive IBD diagnosis were poor. Additional prospective studies concerning the ideal cut-off values, validity and cost-effectiveness of a combined use with the Calprotectin test in the PC setting are necessary.