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,...

Descripción completa

Detalles Bibliográficos
Autores principales: San Miguel Garay, Erik Alejandro, Llaca Díaz, Jorge Martín, Robles Espino, Diana Guadalupe, Díaz Chuc, Erik A., Luna Falcón, Claudio Fabrizio, Ayala de la Cruz, Sergio
Formato: Artículo
Lenguaje:inglés
Publicado: 2023
Materias:
Acceso en línea:http://eprints.uanl.mx/25096/7/24680.pdf
_version_ 1824420083492978688
author San Miguel Garay, Erik Alejandro
Llaca Díaz, Jorge Martín
Robles Espino, Diana Guadalupe
Díaz Chuc, Erik A.
Luna Falcón, Claudio Fabrizio
Ayala de la Cruz, Sergio
author_facet San Miguel Garay, Erik Alejandro
Llaca Díaz, Jorge Martín
Robles Espino, Diana Guadalupe
Díaz Chuc, Erik A.
Luna Falcón, Claudio Fabrizio
Ayala de la Cruz, Sergio
author_sort San Miguel Garay, Erik Alejandro
collection Repositorio Institucional
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.
format Article
id eprints-25096
institution UANL
language English
publishDate 2023
record_format eprints
spelling eprints-250962024-03-07T18:39:25Z http://eprints.uanl.mx/25096/ Urinalysis: diagnostic performance of urine dipstick compared to an automated microscopic method San Miguel Garay, Erik Alejandro Llaca Díaz, Jorge Martín Robles Espino, Diana Guadalupe Díaz Chuc, Erik A. Luna Falcón, Claudio Fabrizio Ayala de la Cruz, Sergio RB Patología 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. 2023-01-05 Article PeerReviewed text en cc_by_nc_nd http://eprints.uanl.mx/25096/7/24680.pdf http://eprints.uanl.mx/25096/7.haspreviewThumbnailVersion/24680.pdf San Miguel Garay, Erik Alejandro y Llaca Díaz, Jorge Martín y Robles Espino, Diana Guadalupe y Díaz Chuc, Erik A. y Luna Falcón, Claudio Fabrizio y Ayala de la Cruz, Sergio (2023) Urinalysis: diagnostic performance of urine dipstick compared to an automated microscopic method. Medicina universitaria, 24 (4). pp. 177-183. ISSN 1665-5796 https://www.medicinauniversitaria.org 10.24875/RMU.22000063
spellingShingle RB Patología
San Miguel Garay, Erik Alejandro
Llaca Díaz, Jorge Martín
Robles Espino, Diana Guadalupe
Díaz Chuc, Erik A.
Luna Falcón, Claudio Fabrizio
Ayala de la Cruz, Sergio
Urinalysis: diagnostic performance of urine dipstick compared to an automated microscopic method
thumbnail https://rediab.uanl.mx/themes/sandal5/images/online.png
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 RB Patología
url http://eprints.uanl.mx/25096/7/24680.pdf
work_keys_str_mv AT sanmiguelgarayerikalejandro urinalysisdiagnosticperformanceofurinedipstickcomparedtoanautomatedmicroscopicmethod
AT llacadiazjorgemartin urinalysisdiagnosticperformanceofurinedipstickcomparedtoanautomatedmicroscopicmethod
AT roblesespinodianaguadalupe urinalysisdiagnosticperformanceofurinedipstickcomparedtoanautomatedmicroscopicmethod
AT diazchucerika urinalysisdiagnosticperformanceofurinedipstickcomparedtoanautomatedmicroscopicmethod
AT lunafalconclaudiofabrizio urinalysisdiagnosticperformanceofurinedipstickcomparedtoanautomatedmicroscopicmethod
AT ayaladelacruzsergio urinalysisdiagnosticperformanceofurinedipstickcomparedtoanautomatedmicroscopicmethod