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Introduction/Objectives: The fecal immunochemical test (FIT) helps triage primary care patients at risk of colorectal cancer (CRC). Improving FIT returns has received recent attention, however uncertainty exists regarding the accurate completion of samples provided for laboratory analysis. This study aims to identify the rejection rate of returned FIT samples and determine rejection causes. Methods: FIT samples from symptomatic patients within South Yorkshire, Bassetlaw, and North Derbyshire are processed at a central laboratory. Tests requests are made from 225 GP practices, which serve an estimated 2 million population. This study describes a retrospective review of FIT samples received in the central laboratory between 01/09/19 and 31/12/22. Locally held data was interrogated in March 2023 to determine the number of FIT samples received and rejected during the study period. Documented reasons for rejection were explored to identify common themes. Results: Total FIT specimens received during the study period was 126 422. Of these, 5190 (4.1%) were rejected. Monthly rejection rates fell from 17.4% in September 2019 to 1.3% in December 2022 (P <.001). Sampling errors were the most frequent cause for FIT rejection (2151/5190), with other causes including: expired specimen; no sample collection date/ time, no request form, incomplete patient information and illegible handwriting. Conclusions: This is the first study exploring FIT rejection rates in symptomatic primary care patients, which shows improvements in rejection rates over time. Targeted interventions could improve rejection rates further, thereby reducing NHS resource use and costs and diagnostic delays. [ABSTRACT FROM AUTHOR]

This study develops a theoretical model for the costs of an exam as a function of its duration. Two kind of costs are distinguished: (1) the costs of measurement errors and (2) the costs of the measurement. Both costs are expressed in time of the student. Based on a classical test theory model, enriched with assumptions on the context, the costs of the exam can be expressed as a function of various parameters, including the duration of the exam. It is shown that these costs can be minimized in time. Applied in a real example with reliability.80, the outcome is that the optimal exam time would be much shorter and would have reliability.675. The consequences of the model are investigated and discussed. One of the consequences is that optimal exam duration depends on the study load of the course, all other things being equal. It is argued that it is worthwhile to investigate empirically how much time students spend on preparing for resits. Six variants of the model are distinguished, which differ in their weights of the errors and in the way grades affect how much time students study for the resit. [ABSTRACT FROM AUTHOR]