Evidence map›Paper›PMID 31873085›Full record

Trial reportScientific reports2019

Identification of clinical and urine biomarkers for uncomplicated urinary tract infection using machine learning algorithms.

Amal A H Gadalla, Ida M Friberg, Ann Kift-Morgan, Jingjing Zhang, Matthias Eberl, Nicholas Topley, Ian Weeks, Simone Cuff, Mandy Wootton, Micaela Gal and 7 more

Abstract readRandomized Controlled Trial
In one paragraph

Trial report in Scientific reports, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 32 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
32citing papers in PubMed, 2 pooled it
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

32 citing papers in PubMed, 2 syntheses or guidelines pooled it.

  1. Pooled it
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  20. Immune defenses in the urinary tract.Trends in immunology · 2023
    Review
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

17 authors.

Amal A H GadallaDivision of Population Medicine, School of Medicine, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom. GadallaA1@cardiff.ac.uk.ORCID http://orcid.org/0000-0002-3131-725X
Ida M FribergDivision of Infection & Immunity, School of Medicine, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom.
Ann Kift-MorganDivision of Infection & Immunity, School of Medicine, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom.
Jingjing ZhangDivision of Infection & Immunity, School of Medicine, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom.
Matthias EberlDivision of Infection & Immunity, School of Medicine, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom.
Nicholas TopleyDivision of Infection & Immunity, School of Medicine, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom.
Ian WeeksSystems Immunity Research Institute, Cardiff University, Cardiff, United Kingdom.
Simone CuffDivision of Infection & Immunity, School of Medicine, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom.
Mandy WoottonSpecialist Antimicrobial Chemotherapy Unit, Public Health Wales Microbiology Cardiff, University Hospital of Wales, Cardiff, United Kingdom.
Micaela GalDivision of Population Medicine, School of Medicine, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom.
Gita ParekhMologic Ltd., Bedford Technology Park, Thurleigh, Bedford, United Kingdom.
Paul DavisMologic Ltd., Bedford Technology Park, Thurleigh, Bedford, United Kingdom.
Clive GregoryDivision of Population Medicine, School of Medicine, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom.
Kerenza HoodCentre for Trials Research, School of Medicine, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom.
Kathryn HughesDivision of Population Medicine, School of Medicine, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom.
Christopher ButlerDivision of Population Medicine, School of Medicine, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom.
Nick A FrancisDivision of Population Medicine, School of Medicine, College of Biomedical and Life Sciences, Cardiff University, Cardiff, United Kingdom.

Funding

Department of Health II-LA-0712-20006Medical Research Council MR/N023145/1
6 · The paper itself

Abstract

Women with uncomplicated urinary tract infection (UTI) symptoms are commonly treated with empirical antibiotics, resulting in overuse of antibiotics, which promotes antimicrobial resistance. Available diagnostic tools are either not cost-effective or diagnostically sub-optimal. Here, we identified clinical and urinary immunological predictors for UTI diagnosis. We explored 17 clinical and 42 immunological potential predictors for bacterial culture among women with uncomplicated UTI symptoms using random forest or support vector machine coupled with recursive feature elimination. Urine cloudiness was the best performing clinical predictor to rule out (negative likelihood ratio [LR-] = 0.4) and rule in (LR+ = 2.6) UTI. Using a more discriminatory scale to assess cloudiness (turbidity) increased the accuracy of UTI prediction further (LR+ = 4.4). Urinary levels of MMP9, NGAL, CXCL8 and IL-1β together had a higher LR+ (6.1) and similar LR- (0.4), compared to cloudiness. Varying the bacterial count thresholds for urine culture positivity did not alter best clinical predictor selection, but did affect the number of immunological predictors required for reaching an optimal prediction. We conclude that urine cloudiness is particularly helpful in ruling out negative UTI cases. The identified urinary biomarkers could be used to develop a point of care test for UTI but require further validation.

Indexed as

AdolescentAdultAgedAged, 80 and overAlgorithmsBiomarkersDiagnosis, Computer-AssistedFemaleHumansImmunologic FactorsInterleukin-1betaInterleukin-8Likelihood FunctionsLipocalin-2Machine LearningMatrix Metalloproteinase 9BiomarkersCXCL8 protein, humanImmunologic FactorsInterleukin-1betaInterleukin-8LCN2 protein, humanLipocalin-2Matrix Metalloproteinase 9MMP9 protein, human

Identifiers

PMID31873085
PMCPMC6928162

What OpenQuestion holds

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Registered trials

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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.