Challa Suryanarayana Reddy, Buluku Gabriel, Gboluaje Temitayo, Chaudhry Ahtshamullah, Kibreab Angesom, Aduli Farshad, Adidam Sneha, Ashktorab Hassan, Laiyemo Adeyinka
Gastroenterology, New York University (NYU) Langone Hospital, Long Island, USA.
Gastroenterology, Howard University College of Medicine, Washington, DC, USA.
Cureus. 2025 Jul 22;17(7):e88524. doi: 10.7759/cureus.88524. eCollection 2025 Jul.
Background Fecal occult blood testing (FOBT) is an outpatient screening tool for colorectal cancer. However, it is widely used in the hospital setting among hospitalized patients for a myriad of reasons. The aim of our study is to understand the knowledge and current utilization of FOBT among internal medicine (IM) residents across multiple training programs in the United States. Methods This was a multicenter survey conducted among 25 IM residency programs. A 15-item questionnaire survey on FOBT was emailed to IM residents in May 2022, at the end of the academic year, with two bi-weekly follow-up reminders. Logistic regression models and Stata statistical software version 14.2 (StataCorp, College Station, TX) were used for the analysis. Those included in the study were IM residents at any level of training. The exclusion criterion was other residents not enrolled in an IM program. Results A total of 227 (100%) IM residents responded to the survey (n=96 (42.2%) in post-graduate year (PGY)-1, n=67 (29.5%) in PGY-2, n=64 (28.2%) in PGY-3). Overall, 151 (66.5%) residents sometimes or always ordered FOBT during their respective training period and 153 (67.4%) ordered this test more often in inpatient than in outpatient settings. Approximately 136 (60%) residents had knowledge of dietary restrictions but only 73 (32%) residents questioned the patients before ordering it. The triggers for ordering FOBT were mostly anemia (174, 32%) followed by a change in stool color (102, 19%), weight loss (99, 18%) and bleeding per rectum (71, 13%). Majority (141, 62%) of the respondents felt influenced by their supervisors and 130 (57.2%) felt that FOBT results will change their management. Overall, as postgraduate year training increased, trainees were less likely to order FOBT for suspected GI bleeding. Conclusion Our survey results showed that residents were influenced by their supervisors and ordered FOBT largely in the inpatient setting. Although there was noted improvement in understanding of the futility of FOBT in suspected acute GI bleeding, more than half of final-year trainees would still order FOBT. There is a need for better education of IM trainees in the utilization of FOBT.
背景 粪便潜血试验（FOBT）是一种用于结直肠癌的门诊筛查工具。然而，由于多种原因，它在医院环境中被广泛应用于住院患者。我们研究的目的是了解美国多个培训项目中的内科（IM）住院医师对FOBT的知识掌握情况和当前使用情况。方法 这是一项在25个IM住院医师培训项目中进行的多中心调查。2022年5月学年结束时，通过电子邮件向IM住院医师发送了一份关于FOBT的15项问卷调查，并进行了两次双周跟进提醒。使用逻辑回归模型和Stata统计软件版本14.2（StataCorp，德克萨斯州大学站）进行分析。纳入研究的是任何培训水平的IM住院医师。排除标准是未参加IM项目的其他住院医师。结果 共有227名（100%）IM住院医师回复了调查（研究生一年级（PGY）-1中有96名（42.2%），PGY-2中有67名（29.5%），PGY-3中有64名（28.2%））。总体而言，151名（66.5%）住院医师在各自的培训期间有时或总是开具FOBT检查，153名（67.4%）住院医师在住院患者中开具该检查的频率高于门诊患者。约136名（60%）住院医师了解饮食限制，但只有73名（32%）住院医师在开具检查前询问过患者。开具FOBT的触发因素主要是贫血（174例，32%），其次是大便颜色改变（102例，19%）、体重减轻（99例，18%）和直肠出血（71例，13%）。大多数（141名，62%）受访者表示受到上级的影响，130名（57.2%）受访者认为FOBT结果会改变他们的管理决策。总体而言，随着研究生年级培训的增加，受训者为疑似胃肠道出血开具FOBT检查的可能性降低。结论 我们的调查结果表明，住院医师受到上级的影响，主要在住院患者中开具FOBT检查。尽管在理解FOBT在疑似急性胃肠道出血中的无用性方面有明显改善，但超过一半的最后一年受训者仍会开具FOBT检查。有必要对IM受训者在FOBT的使用方面进行更好的教育。
