Rectal biopsy leads to surgery in 1 out of every 4 infants: Study

There is an abundance of literature supporting the diagnostic capabilities of rectal biopsy, particularly suction rectal biopsy, with a 95% to 97% sensitivity and 99% specificity . Although the test's accuracy is well established, there is little data outside of single institution studies that lend insight into how frequently providers choose the correct patient. Although rectal biopsy has long been established as the criterion standard for the diagnosis of Hirschsprung disease, little to no information exists regarding nationwide rates of rectal biopsy positivity or interinstitutional variability.

So,researchers sought to determine the national rate of rectal biopsy positivity and factors contributing to institutional variability.

The study design consisted of a retrospective review of the Children's Hospital Association's (CHA) Pediatric Health Information System from 2009 to 2018 identified infants <100 days old with ICD-9/ICD-10 procedural codes for rectal biopsy in addition to codes for pull-through procedures within 500 days of life as a proxy for positive biopsy. A subgroup analysis of only patients biopsied at institutions with positive biopsy rates 1 standard deviation above or below the mean positive biopsy rate (deemed high and low outliers) was performed to better delineate these populations.