SynthesisThe Journal of infection2018
Diagnostic value of symptoms and signs for identifying urinary tract infection in older adult outpatients: Systematic review and meta-analysis.
Synthesis in The Journal of infection, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
21 citing papers in PubMed, 3 syntheses or guidelines pooled it, 38 citations in OpenAlex.
- Is age associated with different vital signs in adults presenting to hospital with bacterial infection? A systematic review and meta-analysis.Age and ageing · 2025Pooled it
- Biomarkers for diagnosing serious bacterial infections in older outpatients: a systematic review.BMC geriatrics · 2019Pooled it
- Limited evidence for diagnosing bacterial skin infections in older adults in primary care: systematic review.BMC geriatrics · 2019Pooled it
- Nurse Decision-making for Suspected Urinary Tract Infections in Nursing Homes: Potential Targets to Reduce Antibiotic Overuse.Journal of the American Medical Directors Association · 2021Trial
- An observational diagnostic accuracy study comparing the urine dipstick with a consensus-based reference standard for the diagnosis of urinary tract infections in older adults.BMC geriatrics · 2026Observational
- Urine flow cytometry in older adults urinary tract infection diagnosis: is it time to reevaluate thresholds for men and women?BMC geriatrics · 2025Article
- Underlying disease risk among patients with fatigue: a population-based cohort study in primary care.The British journal of general practice : the journal of the Royal College of General Practitioners · 2024Article
- Strategies for older people living in care homes to prevent urinary tract infection: the StOP UTI realist synthesis.Health technology assessment (Winchester, England) · 2024Review
- Article
- Is It Safe to Treat Stable Patients with Bacteremic Urinary Tract Infections with High-Resistant-Rate Antibiotics?Diagnostics (Basel, Switzerland) · 2024Article
- Observational
- Diagnosis of urinary tract infections in the hospitalized older adult population in Alberta.PloS one · 2024Article
- The clinical usefulness of guideline-based strategies with and without the role of nonspecific symptoms to predict urinary tract infections in nursing homes: a decision curve analysis.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2024Article
- 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
- Exploration of Primary Care Clinician Attitudes and Cognitive Characteristics Associated With Prescribing Antibiotics for Asymptomatic Bacteriuria.JAMA network open · 2022Article
- Nursing home residents with suspected urinary tract infections: a diagnostic accuracy study.BMC geriatrics · 2022Article
- Atypical Presentation of Bacteremic Urinary Tract Infection in Older Patients: Frequency and Prognostic Impact.Diagnostics (Basel, Switzerland) · 2021Article
- Presence of urinary symptoms in bacteremic urinary tract infection: a retrospective cohort study of Escherichia coli bacteremia.BMC infectious diseases · 2020Article
- Nursing Home Clinicians' Decision to Prescribe Antibiotics for a Suspected Urinary Tract Infection: Findings From a Discrete Choice Experiment.Journal of the American Medical Directors Association · 2020Article
- Diagnosis of urinary tract infection in older persons in the emergency department: To pee or not to pee, that is the question.Emergency medicine Australasia : EMA · 2019Article
Corrections and comments
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Authors and funding
5 authors at 1 institution in 1 country.
Funding
Abstract
objectivesTo critically appraise and evaluate the diagnostic value of symptoms and signs in identifying UTI in older adult outpatients, using evidence from observational studies.
methodsWe searched Medline and Medline in process, Embase and Web of Science, from inception up to September 2017. We included studies assessing the diagnostic accuracy of symptoms and/or signs in predicting UTI in outpatients aged 65 years and above. Study quality was assessed using the QUADAS-2 tool.
resultsWe identified 15 eligible studies of variable quality, with a total of 12,039 participants (range 65-4259), and assessed the diagnostic accuracy of 66 different symptoms and signs in predicting UTI. A number of symptoms and signs typically associated with UTI, such as nocturia, urgency and abnormal vital signs, were of limited use in older adult outpatients. Inability to perform a number of acts of daily living were predictors of UTI: For example, disability in feeding oneself, + ve LR: 11.8 (95% CI 5.51-25.2) and disability in washing one's hands and face, + ve LR: 6.84 (95% CI 4.08-11.5).
conclusionsThe limited evidence of varying quality shows that a number of symptoms and signs traditionally associated with UTI may have limited diagnostic value in older adult outpatients.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.