title: Microalbuminuria testing in diabetes: is a dipstick as effective as laboratory tests?
abstract: The National Service Framework (NSF) for Diabetes (Department of Health, 2002) aims to improve care for people with diabetes. Primary care trusts need to demonstrate the provision of cost-effective and evidence based care. The National Institute for Clinical Excellence guidelines (NICE, 2002) recommend that microalbuminuria is tested annually in people with diabetes, either by a dipstick method or by a laboratory method. A mini systematic review was undertaken to establish whether a dipstick method of detecting microalbuminuria is as effective as a laboratory method. Four databases were searched and studies comparing dipstick and laboratory methods were included. A hand search was also included. The review was further limited to the Micral test II compared to a reference laboratory standard. Four studies met the inclusion criteria and it was concluded that the Micral test II has a high sensitivity but not very high specificity with lower positive predictive value; it was therefore found to be adequate as a screening tool but not as a diagnostic tool. Therefore the Micral II test is not as effective as a laboratory comparator.
authors.affiliation: Bromley Primary Care Trust and King's College, London. jakki.berry@kcl.ac.uk
authors.forename: Jakki
authors.initials: J
authors.lastname: Berry
mesh_terms: D000419:Albuminuria / Q000209:etiology / Q000652:urine*; D048909:Diabetes Complications; D003920:Diabetes Mellitus / Q000652:urine*; D006801:Humans; D012015:Reference Standards; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D016482:Urinalysis / Q000295:instrumentation / Q000379:methods* / Q000592:standards