ArticleThe British journal of general practice : the journal of the Royal College of General Practitioners2010
Validating the prediction of lower urinary tract infection in primary care: sensitivity and specificity of urinary dipsticks and clinical scores in women.
Article in The British journal of general practice : the journal of the Royal College of General Practitioners, 2010. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 27 papers.
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Who cites it
27 citing papers in PubMed.
- Evidence-based appraisal of two guidelines for the diagnosis of suspected, uncomplicated urinary tract infections in primary care: a diagnostic accuracy validation study.The Journal of antimicrobial chemotherapy · 2023Trial
- Trial
- Point-of-care urine culture for managing urinary tract infection in primary care: a randomised controlled trial of clinical and cost-effectiveness.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018Trial
- External validation study of a clinical decision aid to reduce unnecessary antibiotic prescriptions in women with acute cystitis.BMC family practice · 2017Trial
- Antibiotic treatment of acute uncomplicated cystitis based on rapid urine test and local epidemiology: lessons from a primary care series.BMC infectious diseases · 2014Trial
- Women's perspectives on urine sample collection in primary care when presenting with symptoms of urinary tract infection: A qualitative study.Atencion primaria · 2026Article
- Update to the management of recurrent urinary tract infections in women aged 16 years and older.Drug and therapeutics bulletin · 2026Review
- Impact of PA-100 AST System Rapid Antibiotic Susceptibility Test on Antibiotic Prescription for Community-Acquired Urinary Tract Infections in Spanish Primary Care Settings.Antibiotics (Basel, Switzerland) · 2026Article
- Knowledge, attitudes, and practice around urinary tract infections of general practice assistants in the Netherlands: a cross-sectional internet survey.BMC primary care · 2025Article
- Article
- U.S. primary care physician perceptions on barriers to providing guideline-driven care for UTI and recurrent UTI: a qualitative study.BMC primary care · 2024Article
- Performance of an innovative culture-based digital dipstick for detection of bacteriuria.Microbiology spectrum · 2024Article
- Article
- Impact of Menopausal Status and Recurrent UTIs on Symptoms, Severity, and Daily Life: Findings from an Online Survey of Women Reporting a Recent UTI.Antibiotics (Basel, Switzerland) · 2023Article
- Diagnosis and Management of UTI in Primary Care Settings-A Qualitative Study to Inform a Diagnostic Quick Reference Tool for Women Under 65 Years.Antibiotics (Basel, Switzerland) · 2020Article
- Evaluation of a community pharmacy-led test-and-treat service for women with uncomplicated lower urinary tract infection in England.JAC-antimicrobial resistance · 2020Article
- Automated urinalysis combining physicochemical analysis, on-board centrifugation, and digital imaging in one system: A multicenter performance evaluation of the cobas 6500 urine work area.Practical laboratory medicine · 2019Article
- Uncomplicated urinary tract infections in Swedish primary care; etiology, resistance and treatment.BMC infectious diseases · 2019Observational
- Predictors of Symptom Duration and Bacteriuria in Uncomplicated Urinary Tract Infection.Scandinavian journal of primary health care · 2018Article
- Variations in presentation, management, and patient outcomes of urinary tract infection: a prospective four-country primary care observational cohort study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2017Observational
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11 authors.
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Abstract
backgroundDipsticks are one of the most commonly used near-patient tests in primary care, but few clinical or dipstick algorithms have been rigorously developed.
aimTo confirm whether previously documented clinical and dipstick variables and algorithms predict laboratory diagnosis of urinary tract infection (UTI). DESIGN OF STUDY: Validation study.
settingPrimary care.
methodA total of 434 adult females with suspected lower UTI had bacteriuria assessed using the European Urinalysis Guidelines.
resultsSixty-six per cent of patients had confirmed UTI. The predictive values of nitrite, leucocyte esterase (+ or greater), and blood (haemolysed trace or greater) were confirmed (independent multivariate odds ratios = 5.6, 3.5, and 2.1 respectively). The previously developed dipstick rule--based on presence of nitrite, or both leucocytes and blood-- was moderately sensitive (75%) but less specific (66%; positive predictive value [PPV] 81%, negative predictive value [NPV] 57%). Predictive values were improved by varying the cut-off point: NPV was 76% for all three dipstick results being negative; the PPV was 92% for having nitrite and either blood or leucocyte esterase. Urine offensive smell was not found to be predictive in this sample; for a clinical score using the remaining three predictive clinical features (urine cloudiness, dysuria, and nocturia), NPV was 67% for none of the features, and PPV was 82% for three features.
conclusionA clinical score is of limited value in increasing diagnostic precision. Dipstick results can modestly improve diagnostic precision but poorly rule out infection. Clinicians need strategies to take account of poor NPVs.
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