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ARTICLE |

'Routine Urinalysis': Title and subTitle BreakIs the Dipstick Enough? FREE

Seth T. Shaw, Jr, MD; Selina Y. Poon; Edward T. Wong, MD
[+] Author Affiliations

Reprint requests to Box 404, University of Chicago Hospitals and Clinics, 5841 S Maryland Ave, Chicago, IL 60637 (Dr Shaw).


JAMA. 1985;253(11):1596-1600. doi:10.1001/jama.1985.03350350090028
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Results of this study indicated that a protein-negative, blood-negative dipstick result may be used to rule out the necessity for performing a microscopic examination in "routine urinalysis" only if one is willing to accept 13% false-negative results. On the other hand, a protein-, blood-, and leukocyte esterase-negative dipstick result was associated with 1.4% to 3.3% false-negative results. The high sensitivity of the leukocyte esterase— measuring dipstick for microscopically abnormal urine samples was dependent on its ability to detect small numbers of leukocytes only when interpreted five minutes after immersing it in the sample. Various approaches may be used by which these findings could be applied to produce cost savings and also protect the small number of patients who may have dipstick-negative, microscopically positive urine.

(JAMA 1985;253:1596-1600)

REFERENCES

Heimann GA, Frohlich J, Bernstein M:  Physicians' response to abnormal results of routine urinalysis . Can Med Assoc J 1976;; 115:1094-1095.
Fraser CG, Smith BC, Peake MJ:  Effectiveness of an outpatient urine screening program . Clin Chem 1977;;23:2216-2218.
Schumann GB, Greenberg NF:  Usefulness of macroscopic urinalysis as a screening procedure: A preliminary report . Am J Clin Pathol 1979;;71:452-456.
O'Kell RT:  Microscopic urinalysis as a screening procedure . Am J Clin Pathol 1979;; 72:1041-1042.
Benham L, O'Kell RT:  Urinalysis: Minimizing microscopy . Clin Chem 1982;:28:1722.
Statland BE:  Macroscopic analysis of urine . Med Lab Observer 1983;;15:13-15.
Gambino SR, Tiersten D, Jones RN, et al (eds): Laboratory Testing: New and Future Procedures . Tarpon Springs, Fla, Medical Economics Co Inc, 1983;.
Bauer HW, Hasse W, Steck R:  New diagnostic possibilities of the urinary sediment analysis by means of MD-KOVA system . Urologe 1981;; 21:295-299.
Braden M: Evaluation of KOVA-TM System . Fountain Valley, Calif, ICL Scientific, 1982;.
Addis T:  The number of formed elements in the urinary sediment of normal individuals . J Clin Invest 1926;;2:409-415.
Kesson AM, Talbott JM, Gyory AZ:  Microscopic examination of urine . Lancet 1978;;2:809-812.
Race GJ, White MG: Basic Urinalysis . New York, Harper & Row Publishers Inc, 1979;.
Kassirer JP, Gennari JF:  Laboratory evaluation of renal function , in Early LE, Gottschalk CW (eds): Strauss and Welt's Diseases of the Kidney , ed 3. Boston, Little Brown & Co, 1979;, chap 2.
Fassett RG, Horgan BA, Mathew TH:  Detection of glomerular bleeding by phase-contrast microscopy . Lancet 1982;;1:1432-1434.
Stansfeld JM:  The measurement and meaning of pyuria . Arch Dis Child 1962;;37:257-262.
Straffon RA, Engel WJ:  Diagnosis and treatment of urinary tract infection in children . JAMA 1960;;174:1377.
Kusumi RK, Grover PJ, Kunin CM:  Rapid detection of pyuria by leukocyte esterase activity . JAMA 1981;;245:1653-1655.
Brumfitt W:  Urinary cell counts and their value . J Clin Pathol 1965;;18:550-555.
Manual for Laboratory Workload Recording Method . Skokie, Ill, College of American Pathologists, 1984;.

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Heimann GA, Frohlich J, Bernstein M:  Physicians' response to abnormal results of routine urinalysis . Can Med Assoc J 1976;; 115:1094-1095.
Fraser CG, Smith BC, Peake MJ:  Effectiveness of an outpatient urine screening program . Clin Chem 1977;;23:2216-2218.
Schumann GB, Greenberg NF:  Usefulness of macroscopic urinalysis as a screening procedure: A preliminary report . Am J Clin Pathol 1979;;71:452-456.
O'Kell RT:  Microscopic urinalysis as a screening procedure . Am J Clin Pathol 1979;; 72:1041-1042.
Benham L, O'Kell RT:  Urinalysis: Minimizing microscopy . Clin Chem 1982;:28:1722.
Statland BE:  Macroscopic analysis of urine . Med Lab Observer 1983;;15:13-15.
Gambino SR, Tiersten D, Jones RN, et al (eds): Laboratory Testing: New and Future Procedures . Tarpon Springs, Fla, Medical Economics Co Inc, 1983;.
Bauer HW, Hasse W, Steck R:  New diagnostic possibilities of the urinary sediment analysis by means of MD-KOVA system . Urologe 1981;; 21:295-299.
Braden M: Evaluation of KOVA-TM System . Fountain Valley, Calif, ICL Scientific, 1982;.
Addis T:  The number of formed elements in the urinary sediment of normal individuals . J Clin Invest 1926;;2:409-415.
Kesson AM, Talbott JM, Gyory AZ:  Microscopic examination of urine . Lancet 1978;;2:809-812.
Race GJ, White MG: Basic Urinalysis . New York, Harper & Row Publishers Inc, 1979;.
Kassirer JP, Gennari JF:  Laboratory evaluation of renal function , in Early LE, Gottschalk CW (eds): Strauss and Welt's Diseases of the Kidney , ed 3. Boston, Little Brown & Co, 1979;, chap 2.
Fassett RG, Horgan BA, Mathew TH:  Detection of glomerular bleeding by phase-contrast microscopy . Lancet 1982;;1:1432-1434.
Stansfeld JM:  The measurement and meaning of pyuria . Arch Dis Child 1962;;37:257-262.
Straffon RA, Engel WJ:  Diagnosis and treatment of urinary tract infection in children . JAMA 1960;;174:1377.
Kusumi RK, Grover PJ, Kunin CM:  Rapid detection of pyuria by leukocyte esterase activity . JAMA 1981;;245:1653-1655.
Brumfitt W:  Urinary cell counts and their value . J Clin Pathol 1965;;18:550-555.
Manual for Laboratory Workload Recording Method . Skokie, Ill, College of American Pathologists, 1984;.
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