Laboratory Stewardship Update: Point-of-Care Fecal Occult Blood Testing Discontinued

As part of Premier Health's ongoing commitment to clinical standardization, evidence-based care and laboratory stewardship, point-of-care fecal occult blood testing (FOBT) was discontinued in inpatient and emergency department settings effective Oct. 1.

The decision was made through collaboration among laboratory medical directors, physician stakeholders and Premier Health's Clinical Value Committee. The goal is to reduce low-value testing, support appropriate clinical decision-making and improve care for patients.

FOBT, a guaiac-based test that detects blood in stool, is intended for colorectal cancer screening. Historically, it has also been used in hospitalized patients with symptoms such as anemia or suspected gastrointestinal bleeding. However, research has shown that FOBT is not a reliable diagnostic tool in these settings due to its limited sensitivity and the potential for false-positive or false-negative results.

Inappropriate use of FOBT can lead to unnecessary testing, delays in care or missed opportunities for more appropriate diagnostic evaluation. Multiple studies have demonstrated little clinical value for FOBT in emergency and inpatient settings, with evidence showing it increases workload and costs without improving diagnosis or patient outcomes.

Several national medical organizations, including the Society of Hospital Medicine and the American College of Emergency Physicians, have recommended against the use of FOBT in hospitalized patients. Elimination of FOBT has been suggested in the Choosing Wisely campaign and Things We Do for No Reason.

This change reflects Premier Health's continued focus on providing high-quality, evidence-based care while ensuring the appropriate use of clinical resources.

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