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Family Practice Vol. 20, No. 4, 410-412
© Oxford University Press 2003

Clinical Research

Validity of the urine dipslide under daily practice conditions

Ron Winkensa,b, Hanny Nelissen-Aretsb and Ellen Stobberinghc

a Transmural Care Unit
c Department of Medical Microbiology, University Hospital Maastricht and
b Department of General Practice, Maastricht University, The Netherlands.

Correspondence to Ron AG Winkens, Transmural Care Unit (BZeVII), University Hospital Maastricht, PO Box 5800, 6202 AZ, Maastricht, The Netherlands; E-mail: ron.winkens{at}hag.unimaas.nl

Background. So far, the validity of urine dipslides has been studied only under optimal conditions, which may not reflect the situation in daily practice.

Objective. We studied the validity of the urine dipslide as performed under daily practice conditions and assessed the influence of the incubation period (24 h versus 48 h) on validity.

Methods. Fresh urine samples of patients with signs/symptoms of a possible urinary tract infection (UTI) were examined in general practice via a nitrite test, a urine sediment and a dipslide. A second dipslide was inoculated and sent to the hospital microbiology laboratory for culture. This culture acted as gold standard. We calculated the sensitivity and specificity of the tests performed.

Results. Of the 273 patient episodes included, 62% had a UTI (166 of 268 cultures). The sensitivity of the dipslide performed in daily general practice was 73% and the specificity was 94%.

Conclusion. The validity of the dipslide read under practice conditions is lower than under optimal conditions. Actions to improve performance are needed. Nonetheless, using the dipslide instead of the sediment as a second step after the nitrite test would improve the diagnostic work-up of UTI.

Keywords. External validity, sensitivity, specificity, urine dipslide.


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