Urinalysis: diagnostic performance of urine dipstick compared to an automated microscopic method
Introduction: Urinalysis is one of the most important clinical laboratory tests because numerous pathologies can manifest or be suspected through this test. Although the previous reports mention that urinary microscopy is a fundamental part of urinalysis for diagnostic support of various conditions,...
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Permanyer
2022-10-01
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| Series: | Medicina Universitaria |
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| Online Access: | https://www.medicinauniversitaria.org/frame_esp.php?id=189 |
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| author | Erik A. San Miguel-Garay Jorge M. Llaca-Díaz Diana G. Robles-Espino Erik A. Díaz-Chuc Claudio F. Luna-Falcón Sergio Ayala-De la Cruz |
| author_facet | Erik A. San Miguel-Garay Jorge M. Llaca-Díaz Diana G. Robles-Espino Erik A. Díaz-Chuc Claudio F. Luna-Falcón Sergio Ayala-De la Cruz |
| author_sort | Erik A. San Miguel-Garay |
| collection | DOAJ |
| description | Introduction: Urinalysis is one of the most important clinical laboratory tests because numerous pathologies can manifest or be suspected through this test. Although the previous reports mention that urinary microscopy is a fundamental part of urinalysis for diagnostic support of various conditions, there is a debate about the utility of this test section in a certain patient population. The aim of this study was to determine the diagnostic performance of the urinary dipstick analysis and the potential risks of false-negative (FN) results. Material and methods: This is a retrospective and observational study, and urinalysis information was obtained from non-hospitalized patients. The dipstick and microscopic analyses were performed using the Clinitek- ATLAS (index test) and iQ200-SPRINT (reference standard) devices. Dipstick or microscopy analyses were positive if ≥ 1 parameters were abnormal. A Bayesian hierarchal beta-binomial model was carried out for each performance parameter. Risk analysis was performed as proposed in the literature. Results: Five hundred and fifty-two patients were included in the study. The posterior median at group level was 94% (credible interval 95% [CrI 95%] 89.9-97%) for sensitivity (Se), 57.1% (CrI 95%, 50.1-64.1%) for specificity, and 5.8% (CrI 95%, 2.59-9.64%) for FN rate (FNR). The posterior probability Se > 90% was 95.9% at a group level. The risk analysis found only low-risk false-negative events. Conclusions: The performance of the dipstick analysis was appropriate, with a good certainty of Se > 90% and a FNR < 10% at the operator level. Omission of microscopic analysis can be a safe action in a patient with a negative dipstick since FNs with a clinical impact are not expected.
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| issn | 1665-5796 2530-0709 |
| language | English |
| last_indexed | 2024-04-11T00:02:51Z |
| publishDate | 2022-10-01 |
| publisher | Permanyer |
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| series | Medicina Universitaria |
| spelling | doaj.art-fd61993998ff40a8bd35ac918f4c33fc2023-01-09T21:33:55ZengPermanyerMedicina Universitaria1665-57962530-07092022-10-0124410.24875/RMU.22000063Urinalysis: diagnostic performance of urine dipstick compared to an automated microscopic methodErik A. San Miguel-Garay0Jorge M. Llaca-Díaz1Diana G. Robles-Espino2Erik A. Díaz-Chuc3Claudio F. Luna-Falcón4Sergio Ayala-De la Cruz5Department of Clinical Pathology, Facultad de Medicina, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, MéxicoDepartment of Clinical Pathology, Facultad de Medicina, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, MéxicoDepartment of Clinical Pathology, Facultad de Medicina, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, MéxicoDepartment of Clinical Pathology, Facultad de Medicina, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, MéxicoDepartment of Clinical Pathology, Facultad de Medicina, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, MéxicoDepartment of Clinical Pathology, Facultad de Medicina, Hospital Universitario “Dr. José Eleuterio González”, Universidad Autónoma de Nuevo León, Monterrey, Nuevo León, MéxicoIntroduction: Urinalysis is one of the most important clinical laboratory tests because numerous pathologies can manifest or be suspected through this test. Although the previous reports mention that urinary microscopy is a fundamental part of urinalysis for diagnostic support of various conditions, there is a debate about the utility of this test section in a certain patient population. The aim of this study was to determine the diagnostic performance of the urinary dipstick analysis and the potential risks of false-negative (FN) results. Material and methods: This is a retrospective and observational study, and urinalysis information was obtained from non-hospitalized patients. The dipstick and microscopic analyses were performed using the Clinitek- ATLAS (index test) and iQ200-SPRINT (reference standard) devices. Dipstick or microscopy analyses were positive if ≥ 1 parameters were abnormal. A Bayesian hierarchal beta-binomial model was carried out for each performance parameter. Risk analysis was performed as proposed in the literature. Results: Five hundred and fifty-two patients were included in the study. The posterior median at group level was 94% (credible interval 95% [CrI 95%] 89.9-97%) for sensitivity (Se), 57.1% (CrI 95%, 50.1-64.1%) for specificity, and 5.8% (CrI 95%, 2.59-9.64%) for FN rate (FNR). The posterior probability Se > 90% was 95.9% at a group level. The risk analysis found only low-risk false-negative events. Conclusions: The performance of the dipstick analysis was appropriate, with a good certainty of Se > 90% and a FNR < 10% at the operator level. Omission of microscopic analysis can be a safe action in a patient with a negative dipstick since FNs with a clinical impact are not expected. https://www.medicinauniversitaria.org/frame_esp.php?id=189Urinalysis. Urine dipstick. Urine microscopy. Risk analysis. Dipstick performance. |
| spellingShingle | Erik A. San Miguel-Garay Jorge M. Llaca-Díaz Diana G. Robles-Espino Erik A. Díaz-Chuc Claudio F. Luna-Falcón Sergio Ayala-De la Cruz Urinalysis: diagnostic performance of urine dipstick compared to an automated microscopic method Medicina Universitaria Urinalysis. Urine dipstick. Urine microscopy. Risk analysis. Dipstick performance. |
| title | Urinalysis: diagnostic performance of urine dipstick compared to an automated microscopic method |
| title_full | Urinalysis: diagnostic performance of urine dipstick compared to an automated microscopic method |
| title_fullStr | Urinalysis: diagnostic performance of urine dipstick compared to an automated microscopic method |
| title_full_unstemmed | Urinalysis: diagnostic performance of urine dipstick compared to an automated microscopic method |
| title_short | Urinalysis: diagnostic performance of urine dipstick compared to an automated microscopic method |
| title_sort | urinalysis diagnostic performance of urine dipstick compared to an automated microscopic method |
| topic | Urinalysis. Urine dipstick. Urine microscopy. Risk analysis. Dipstick performance. |
| url | https://www.medicinauniversitaria.org/frame_esp.php?id=189 |
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