TABLE 4.
Comparison of responses among Winnipeg Regional Health Authority physicians
| Question | General IM (n=13) | GI (n=6) | Other IM (n=27) | GS (n=13) | EM (n=40) | FM (n=20) | P |
|---|---|---|---|---|---|---|---|
| Do not use FOBT in hospitalized patients | 85 | 67 | 56 | 77 | 26 | 11 | <0.001 |
| Believe FOBT is of value among emergency room patients | 8 | 33 | 68 | 23 | 79 | 61 | <0.001 |
| Believe FOBT is of value among inpatients | 15 | 33 | 88 | 31 | 95 | 94 | <0.001 |
| Indication(s) that a respondent would use a FOBT among hospitalized patients | |||||||
| Black stools | 27 | 33 | 33 | 8 | 87 | 58 | <0.001 |
| Anemia with iron deficiency | 9 | 17 | 75 | 42 | 55 | 63 | <0.001 |
| Anemia without iron deficiency | 9 | 33 | 54 | 25 | 53 | 53 | 0.062 |
| Undiagnosed gastrointestinal symptoms | 9 | 17 | 17 | 0 | 50 | 53 | <0.001 |
| Colorectal cancer screening | 0 | 0 | 42 | 17 | 21 | 16 | 0.036 |
| Obtain objective evidence of gastrointestinal bleeding | 18 | 0 | 25 | 8 | 53 | 26 | <0.001 |
| Do not use FOBT in hospitalized patients | 81 | 66 | 42 | 75 | 5 | 0 | <0.001 |
| Over the preceding six months, proportion of patients in whom the result of an FOBT altered clinical management among patients for whom an FOBT was ordered by the respondent or by another physician | |||||||
| 0 | 36 | 17 | 26 | 46 | 15 | 25 | 0.293 |
| 1–25 | 45 | 0 | 15 | 15 | 36 | 44 | 0.066 |
| 26–50 | 0 | 0 | 33 | 8 | 18 | 6 | 0.082 |
| 51–75 | 0 | 17 | 11 | 8 | 5 | 6 | 0.638 |
| 76–100 | 0 | 17 | 0 | 0 | 13 | 19 | 0.040 |
| Do not use FOBT among hospitalized patients | 36 | 50 | 15 | 23 | 8 | 0 | 0.008 |
| If FOBT was performed, it was performed at the bedside | 40 | 50 | 5 | 0 | 100 | 33 | <0.001 |
| If FOBT was performed, it was sent to the laboratory | 100 | 50 | 89 | 100 | 6 | 82 | <0.001 |
| If FOBT was sent to the laboratory, three samples were sent | 50 | 0 | 68 | 75 | 13 | 82 | <0.001 |
| If FOBT was positive, for inpatients <50 years of age, proportion of patients who underwent a colonoscopy | |||||||
| 0 | 45 | 33 | 30 | 63 | 17 | 6 | 0.028 |
| 1–25 | 45 | 33 | 11 | 0 | 37 | 20 | 0.031 |
| 26–50 | 0 | 17 | 7 | 13 | 10 | 20 | 0.573 |
| 51–75 | 0 | 17 | 15 | 25 | 23 | 20 | 0.567 |
| 76–100 | 1 | 0 | 37 | 0 | 13 | 33 | 0.058 |
| If FOBT was positive, for inpatients >50 years of age, proportion of patients who underwent a colonoscopy | |||||||
| 0 | 18 | 17 | 27 | 63 | 20 | 0 | 0.019 |
| 1–25 | 44 | 33 | 8 | 0 | 20 | 19 | 0.168 |
| 26–50 | 11 | 0 | 12 | 0 | 10 | 13 | 0.990 |
| 51–75 | 11 | 33 | 15 | 13 | 30 | 50 | 0.113 |
| 76–100 | 33 | 17 | 38 | 25 | 20 | 19 | 0.688 |
| Lack of dietary restrictions WOULD alter interpretation of FOBT | 46 | 66 | 19 | 33 | 22 | 11 | 0.048 |
| Lack of waiting for processing of FOBT WOULD alter its interpretation | 31 | 33 | 11 | 33 | 23 | 11 | 0.391 |
| Comfortable if bedside testing for FOBT were no longer available in favour of STAT laboratory testing | 85 | 83 | 95 | 92 | 32 | 76 | <0.001 |
| Would like FOBT reported: | |||||||
| Within 1 h | 8 | 33 | 12 | 8 | 65 | 18 | <0.001 |
| Within 2 h to 4 h | 8 | 0 | 27 | 8 | 23 | 29 | 0.436 |
| Within 24 h | 85 | 66 | 62 | 83 | 13 | 53 | <0.001 |
| Would like fecal immunochemical test introduced in hospitals | 46 | 83 | 64 | 67 | 40 | 78 | 0.227 |
| If the fecal immunochemical test was available, indication(s) for ordering it | |||||||
| Diagnostic aid | 15 | 0 | 41 | 8 | 57 | 47 | 0.004 |
| Colorectal cancer screening | 23 | 66 | 22 | 58 | 10 | 18 | 0.005 |
| Both diagnostic aid and colorectal cancer screening | 23 | 33 | 19 | 25 | 10 | 29 | 0.208 |
| Would not use it | 39 | 0 | 19 | 8 | 23 | 6 | 0.208 |
Data presented as % unless otherwise indicated, percentages are based on the number of the individuals responding to the specific item in the survey questionnaire. EM Emergency medicine; FM Family medicine; FOBT Fecal occult blood test; GI Gastroenterologists; GS General surgeons; IM Internal medicine; STAT Immediate