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Table 1 Distribution and accuracy of individual predictors for diagnosing SCD in primary care as observed in 810 Dutch patients with lower abdominal complaints referred for endoscopy in the CEDAR studya

From: Is there an added value of faecal calprotectin and haemoglobin in the diagnostic work-up for primary care patients suspected of significant colorectal disease? A cross-sectional diagnostic study

Ā 

Diagnostic accuracy for SCD

Ā Ā 
Ā 

SCD (nā€‰=ā€‰141; 17.4Ā %)

No SCD (nā€‰=ā€‰669; 82.6Ā %)

Ā Ā 

Diagnostic predictorb

Distribution in CEDAR study, %c

Sensitivity, % (95Ā % CI)

PPV, % (95Ā % CI)

Specificity, % (95Ā % CI)

NPV, % (95Ā % CI)

AUC (95Ā % CI)

Percent missing

Patient history

ā€ƒMale sex

45.1

48.2 (40.1ā€“56.4)

18.6 (15.0ā€“22.9)

55.6 (51.8ā€“59.3)

83.6 (79.9ā€“86.7)

ā€“

0.0

ā€ƒAge in years, median (minā€“max)

61 (19ā€“92)

ā€“

ā€“

ā€“

ā€“

0.602 (0.553ā€“0.652)

0.0

ā€ƒAbsence of abdominal pain

19.3

33.0 (25.7ā€“41.1)

29.7 (23.1ā€“37.3)

83.5 (80.5ā€“86.1)

85.5 (82.6ā€“88.0)

ā€“

0.4

ā€ƒDuration of abdominal pain in weeks, median (minā€“max)

90 (0ā€“10 years)d

ā€“

ā€“

ā€“

ā€“

0.597 (0.543ā€“0.652)e

7.4

ā€ƒRectal blood loss

43.6

66.0 (57.8ā€“73.3)

26.3 (22.0ā€“31.1)

61.1 (57.3ā€“64.7)

89.5 (86.3ā€“92.0)

ā€“

0.6

ā€ƒRectal mucus

38.0

51.3 (43.1ā€“59.5)

23.5 (19.1ā€“28.6)

64.9 (61.2ā€“68.4)

86.3 (83.1ā€“89.1)

ā€“

1.2

ā€ƒWeight loss

19.2

23.8 (17.4ā€“31.5)

21.6 (15.8ā€“28.7)

81.8 (78.7ā€“84.6)

83.6 (80.5ā€“86.2)

ā€“

0.7

ā€ƒChange in bowel habit

65.5

68.0 (58.6ā€“76.4)

18.1 (14.9ā€“21.7)

35.1 (31.4ā€“38.9)

83.9 (78.8ā€“88.1)

ā€“

12.3

ā€ƒAbsence of abdominal bloating

45.0

60.5 (52.1ā€“68.4)

23.4 (19.3ā€“28.1)

58.3 (54.5ā€“62.1)

87.5 (84.1ā€“90.3)

ā€“

4.2

ā€ƒAbsence of fever

89.0

89.2 (83.0ā€“93.4)

17.4 (14.8ā€“20.4)

11.0 (8.9ā€“13.6)

82.9 (73.7ā€“89.4)

ā€“

0.6

ā€ƒAbsence of constipation

42.1

50.0 (41.8ā€“58.2)

20.7 (16.7ā€“25.3)

59.6 (55.7ā€“63.3)

85.0 (81.4ā€“87.9)

ā€“

3.5

ā€ƒDiarrhoea

29.1

29.4 (22.4ā€“37.4)

17.6 (13.2ā€“23.0)

71.0 (67.4ā€“74.3)

82.7 (79.3ā€“85.5)

ā€“

1.6

ā€ƒAbsence of family history of CRC

81.7

84.3 (76.0ā€“90.6)

17.9 (15.1ā€“21.1)

18.8 (15.7ā€“22.3)

85.0 (77.6ā€“90.7)

ā€“

14.2

Physical examination

ā€ƒAbsence of palpable abdominal mass

95.2

95.6 (89.5ā€“99.3)

17.5 (14.9ā€“20.4)

4.9 (3.4ā€“6.9)

84.4 (67.3ā€“95.3)

ā€“

14.8

ā€ƒAbnormal digital rectal examination

7.8

11.5 (6.6ā€“18.5)

25.7 (14.5ā€“39.7)

92.9 (89.8ā€“95.5)

83.3 (80.4ā€“85.8)

ā€“

17.7

Blood analyses

Ā Ā Ā Ā Ā Ā Ā 

ā€ƒHb in g/dL, mean (SD)

14.2 (1.3)

ā€“

ā€“

ā€“

ā€“

0.556 (0.502ā€“0.610)f

4.4

ā€ƒAnaemia (ā™€ā€‰<ā€‰12 and ā™‚ā€‰<ā€‰13Ā g/dL)

5.5

9.9 (5.8ā€“16.0)

31.0 (18.9ā€“46.1)

95.4 (93.4ā€“96.8)

83.4 (80.6ā€“85.9)

ā€“

4.4

ā€ƒCRP in mg/L, median (minā€“max)

2 (0ā€“20)d

ā€“

ā€“

ā€“

ā€“

0.587 (0.535ā€“0.638)

4.6

ā€ƒElevated CRP (ā‰„10Ā mg/L)

9.4

12.2 (7.5ā€“18.9)

22.7 (14.5ā€“33.5)

91.2 (88.8ā€“93.2)

83.1 (80.2ā€“85.7)

ā€“

4.6

Faecal tests

ā€ƒCalprotectin POC test in Ī¼g/g, median (minā€“max)

48 (30ā€“300)

ā€“

ā€“

ā€“

ā€“

0.681 (0.629ā€“0.732)

5.6

ā€ƒPositive calprotectin POC test (>50Ā Ī¼g/gg)

48.7

69.6 (61.4ā€“76.7)

24.9 (20.8ā€“29.4)

55.7 (51.8ā€“59.5)

89.7 (86.4ā€“92.3)

ā€“

5.6

ā€ƒCalprotectin ELISA test in Ī¼g/g, median (minā€“max)

62 (8ā€“500)d

ā€“

ā€“

ā€“

ā€“

0.661 (0.606ā€“0.716)

8.6

ā€ƒPositive calprotectin ELISA test (>50Ā Ī¼g/gg)

56.6

71.4 (63.2ā€“78.5)

21.9 (18.4ā€“26.0)

46.5 (42.6ā€“50.4)

88.5 (84.7ā€“91.5)

ā€“

8.6

ā€ƒPositive POC FIT (>6Ā Ī¼g Hb/gh)

25.1

67.2 (58.9ā€“74.5)

46.5 (39.6ā€“53.7)

83.7 (80.5ā€“86.6)

92.4 (89.9ā€“94.3)

ā€“

6.2

  1. AUC area under the receiver operating characteristic curve; CEDAR Cost-Effectiveness of a Decision rule for Abdominal complaints in primary caRe; CI confidence interval; CRC colorectal cancer; CRP C-reactive protein; ELISA enzyme-linked immunosorbent assay; FIT faecal immunochemical test for haemoglobin; Hb haemoglobin; NPV negative predictive value; POC point-of-care; PPV positive predictive value; SCD significant colorectal disease; SD standard deviation
  2. aDistribution and accuracy estimates per diagnostic predictor are following multiple imputation of missing values
  3. bPredictors are coded such that the reported category indicates a higher risk of SCD, to allow direct comparison of accuracy measures across predictors
  4. cIf not otherwise stated
  5. dOutliers were truncated
  6. eNegative relation with presence of SCD
  7. fU-shape relation with presence of SCD
  8. gManufacturerā€™s threshold
  9. hLower detection limit as stated by manufacturer