title: The usefulness of urine fluorescence for suspected antifreeze ingestion in children.
abstract: OBJECTIVE
  To evaluate urine fluorescence as a diagnostic tool.
  
  
  METHODS
  Using a Wood lamp, 60 physicians, assigned to group 1 or 2, independently rated 150 urine specimens from nonpoisoned children as fluorescent or nonfluorescent. Interobserver and intraobserver agreements were assessed. Physician ratings were compared with fluorometry results. The prevalence of urine fluorescence was determined by fluorometry.
  
  
  RESULTS
  Group 1 reported fluorescence in 80.7% (95% CI 73.4%-86.6%) of urine specimens; group 2 reported fluorescence in 69.3% (95% CI 61.3%-76.5%). Interrater agreement was poor (72.5%, kappa = 0.25, 95% CI 0.13-0.37); intrarater agreement was good (physician group 1: 97.9%, kappa = 0.93, 95% CI 0.77-1.00; physician group 2: 93.3%, kappa = 0.85, 95% CI 0.69-1.00). The prevalence of urine fluorescence was 100% (95% CI 98.1%-100%).
  
  
  CONCLUSIONS
  Our data suggest that determination of urine fluorescence using a Wood lamp is a poor screening tool for suspected antifreeze ingestion in children.
authors.affiliation: Department of Pediatrics Jacobi Medical Center, Albert Einstein College of Medicine, Bronx, NY 10461, USA.
authors.forename: Tania
authors.initials: T
authors.lastname: Parsa
authors.forename: Sandra J
authors.initials: SJ
authors.lastname: Cunningham
authors.forename: Stephen P
authors.initials: SP
authors.lastname: Wall
authors.forename: Steven C
authors.initials: SC
authors.lastname: Almo
authors.forename: Ellen F
authors.initials: EF
authors.lastname: Crain
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D004635:Emergency Medicine / Q000295:instrumentation / Q000379:methods*; D019855:Ethylene Glycol / Q000506:poisoning* / Q000652:urine*; D005260:Female; D005453:Fluorescence; D005470:Fluorometry / Q000295:instrumentation / Q000379:methods; D006801:Humans; D007223:Infant; D008297:Male; D015588:Observer Variation; D011041:Poisoning / Q000175:diagnosis / Q000652:urine; D012680:Sensitivity and Specificity; D014556:Urine / Q000737:chemistry*
chemical_list: D019855:Ethylene Glycol