Among ill medical patients, what is the prevalence of abnormal urinalyses that are due to the underlying medical illness, vs abnormal urinalyses due to a co-existing urinary infection(I think I recall seeing data on this, but now cannot find it)
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- Answered 20 Jun 2019 Conflict of interest declaration: None Unfortunately, I was unable to find anything useful. I found isolated articles discussing differential diagnosis of UTI versus conditions such as overactive bladder – but gave no figures as to the proportion. Via Twitter (I asked Twitter for help) someone suggested that it is very context specific and therefore impossible to give a general answer. Another message (DM) stated: “There are multiple conditions that affect the sensitivity and specificity of urine dip testing .... whereas direct microscopy, machine analytics and culture, will be least affected. Local laboratory facilities would be best placed to answer this question and are likely to be more situationally accurate. As with all metabolic tests they need to be taken in the medical context of the patient along with history of complaint and physical signs.”
- Answered 20 Jun 2019 Conflict of interest declaration: None Another response from Twitter: ...depends ++ on age & comorbidities, I expect (e.g. young single illness M, cf >80F with >5 pre-existing diagnoses) Asymptomatic bacteriuria v common in older pts They link to https://onlinelibrary.wiley.com/doi/full/10.1111/jgs.14907
- Answered 20 Jun 2019 Conflict of interest declaration: None Good old Twitter, a further tweet (https://twitter.com/sean9n/status/1141653831664701446) was: "Off top of my head, walking down corridor, I think around 90% +ve dipstick for older women in long term care. Paper by sundvall I think may have answer" I believe he was referring to this paper The Development of a Decision Tool for the Empiric Treatment of Suspected Urinary Tract Infection in Frail Older Adults: A Delphi Consensus Procedure https://www.ncbi.nlm.nih.gov/pubmed/29910137 This is in a very specific population!
- Answered 28 Jun 2019 Conflict of interest declaration: None Thanks for the info.... not yet the piece I think I recall seeing, but the Finucane piece is very helpful