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| ID | Type | Description | Link |
|---|---|---|---|
| AOR14082 | Other Identifier | Department of Clinical Research & Development - APHP |
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This study aims to characterize the diagnostic performance of immunological testing of occult gastrointestinal bleeding in stool in the population aged over 75 years with iron deficiency anemia.
As secondary objectives, the study aims to:
Immunological testing will be performed systematically for each patient.
Research of blood in fecal sample will be based on 2 methods: one based on a qualitative immunochromatographic method (such as HemSign4 technique, Servibio, France; or all other techniques used at AP-HP) and another quantitative immunoturbidimetric method (OC-Sensor, Eiken, Japan). They will be performed systematically with two fresh fecal samples for each patient, before coloscopy examination.
Treating physicians will not be provided with the testing result. The diagnosis of reference will be established by experts based on the result of explorations (colonoscopy, coloscanner) and the patient's progression, blinded to the result of immunoassay.
The intrinsic characteristics of the immunoassay (sensitivity, specificity...) will be determined with reference to this reference diagnosis, using a positivity threshold defined using expert consensus on the weights to be allocated to potential errors.
2 modeling scenarios (without vs with immunological testing) using decision trees based on prevalence and diagnostic performance observed and stochastic simulations.
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| Measure | Description | Time Frame |
|---|---|---|
| Sensitivity of immunological test with OC-SENSOR supplies | The immunological test with OC-SENSOR supplies is a quantitative determination of hemoglobin, the method of detection of lower gastrointestinal hemorrhagic lesions of older population with iron deficiency anemia. Sensitivity of the immunological test will be calculated statistically. | At baseline |
| Specificity of immunological test with OC-SENSOR supplies | The immunological test with OC-SENSOR supplies is a quantitative determination of hemoglobin, the method of detection of lower gastrointestinal hemorrhagic lesions of older population with iron deficiency anemia. Specificity of the immunological test will be calculated statistically. | At baseline |
| Likelihood ratios of immunological test with OC-SENSOR supplies | The immunological test with OC-SENSOR supplies is a quantitative determination of hemoglobin, the method of detection of lower gastrointestinal hemorrhagic lesions of older population with iron deficiency anemia. Likelihood rations of the immunological test will be calculated statistically. | At baseline |
| Measure | Description | Time Frame |
|---|---|---|
| Diagnostic Performance | Diagnostic Performance of predictive equation incorporating all individual data will be calculated statistically. | At baseline |
| Comparing scenarios using decision trees |
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Inclusion Criteria:
Exclusion Criteria:
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200 people at least 75 years old.
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| Name | Affiliation | Role |
|---|---|---|
| Dominique Lamarque, MD, PhD | Service Hépato-Gastroentérologie, Hôpital Ambroise Paré | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Service Hépato-Gastroentérologie, Hôpital Ambroise Paré | Boulogne-Billancourt | Hauts-de-Seine | 92100 | France |
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Fecal Occult Blood Test
Compare using modeling (decision trees) the causal efficiency (number of origins of bleeding detected / number of coloscopy-colonoscopy performed) of two scenarios: without (base case) and with the immunoassay to research occult bleeding in feaces (with one or two fecal samples).
| At baseline |
| Performance of the test when used with an optimized positivity threshold | Sensitivity, specificity and likelihood ratios of the immunological testing will be calculated statistically, when an optimized positivity threshold for the population under study is used, as a function of weights (defined by experts consensus) allocated to errors (false negative and false positive cases). | At baseline |
| ID | Term |
|---|---|
| D018798 | Anemia, Iron-Deficiency |
| ID | Term |
|---|---|
| D000747 | Anemia, Hypochromic |
| D000740 | Anemia |
| D006402 | Hematologic Diseases |
| D006425 | Hemic and Lymphatic Diseases |
| D000090463 | Iron Deficiencies |
| D019189 | Iron Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
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