Evidence map›Paper›PMID 34652709›Full record

ReviewEuropean geriatric medicine2019

Which near-patient tests might improve the diagnosis of UTI in older people in urgent care settings? A mapping review and consensus process.

Molly Jameson, Mary Edmunds Otter, Christopher Williams, Deborah Modha, Felicia Lim, Simon P Conroy

Open access · greenAbstract readReview
PubMed Publisher
In one paragraph

Review in European geriatric medicine, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 1 paper.

0numbers the graph read from it
0cells of the map it votes in
1citing papers in PubMed
–field-weighted citation impact, top 87% of its field
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

1 citing paper in PubMed, 2 citations in OpenAlex.

  1. Article
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

6 authors at 2 institutions in 1 country.

Molly JamesonDepartment of Health Sciences, University of Leicester, George Davies Centre, Room 3.37, University Road, Leicester, LE1 7RH, UK.
Mary Edmunds OtterDepartment of Health Sciences, University of Leicester, George Davies Centre, Room 3.37, University Road, Leicester, LE1 7RH, UK.
Christopher WilliamsDepartment of Health Sciences, University of Leicester, George Davies Centre, Room 3.37, University Road, Leicester, LE1 7RH, UK.
Deborah ModhaDepartment of Microbiology, University Hospitals of Leicester, Leicester, UK.
Felicia LimDepartment of Microbiology, University Hospitals of Leicester, Leicester, UK.
Simon P ConroyDepartment of Health Sciences, University of Leicester, George Davies Centre, Room 3.37, University Road, Leicester, LE1 7RH, UK. spc3@le.ac.uk.ORCID http://orcid.org/0000-0002-4306-6064
University of Leicester · GBUniversity Hospitals of Leicester NHS Trust · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purposeThe aim of this study was to map out the existing knowledge on near-patient tests for urinary tract infections, and use a consensus building approach to identify those which might be worthy of further evaluation in the urgent care context, defined as clinically useful and feasible results available within 4-24 h.

methodsA systematic search for reviews describing diagnostic tests for UTI was undertaken in Medline, EMBASE, Cochrane database of systematic reviews and CINAHL selected reviews were retained according to a priori inclusion and exclusion criteria, and then graded for quality using the CASP tool for reviews. A consensus process involving microbiologists and chemical pathologists helped identify which test might conceivably be applied in the urgent care context (e.g. Emergency Department, giving results within 24 h).

resultsThe initial search identified 1079 papers, from which 26 papers describing 35 diagnostic tests were retained for review. The overall quality was limited, with only 7/26 retained papers scoring more than 50% on the CASP criteria. Reviews on urine dipstick testing reported wide confidence intervals for sensitivity and specificity; several raised concerns about urine dip testing in older people. A number of novel biomarkers were reported upon but appeared not to be helpful in differentiating infection from asymptomatic bacteriuria. Blood markers such as CRP and procalcitonin were reported to be helpful in monitoring rather than diagnosing UTI. The consensus process helped to refine the 35 test down to 17 that might be useful in the urgent care context: urinalysis (nitrites and leucocytes), uriscreen catalase test, lactoferrin, secretory immunoglobulin A, xanthine oxidase, soluble triggering receptor expressed on myeloid cells, A-1 microglobulin (a1 Mg) and a1 Mg/creatinine ratio, cytokine IL-6, RapidBac, MALDI-TOF, electronic noses, colorimetric sensor arrays, electro chemical biosensor, WBC count (blood), C-reactive peptide, erythrocyte sedimentation rate.

conclusionsA wide range of diagnostic tests have been explored to diagnose UTI, but, in general, have been poorly evaluated or have wide variation in predictive properties. This study identified 17 tests for UTI that seemed to offer some primes and merit further evaluation for diagnosing UTI in older people in urgent care settings.

Indexed as

Diagnostic testingOlder peopleSystematic reviewUrinary tract infection

Identifiers

PMID34652709
OpenAlexW2969542223

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.