title: The usefulness of a free self-test for screening albuminuria in the general population: a cross-sectional survey.
abstract: BACKGROUND
  In this study we evaluated the usefulness of a free self-test for screening albuminuria in the general population.
  
  
  METHODS
  Dutch adults were invited by the Dutch Kidney Foundation to order a free albuminuria self-test, consisting of three semi quantitative dipstick tests, via the Internet. Results were classified in negative, low-positive and high-positive. In case of a positive test result, the tester was recommended to visit a GP for supplementary examination and/or treatment. Participants of the programme were sent a questionnaire for evaluation by e-mail eight weeks after receiving the self-test.
  
  
  RESULTS
  During the first 30 days of the self-test programme, 996,927 self-tests were ordered. In total, 71,714 participants completed the questionnaire: 79% had a negative test result and 21% had a positive test result (20% low-positive and 1% high-positive). Of the positive testers, 25% visited a GP after testing for albuminuria. Among the 3,983 participants who visited a GP, 193 new diseases were detected: 25 chronic renal failure, 152 hypertension and 31 diabetes mellitus.
  
  
  CONCLUSIONS
  Using a free self-test for screening albuminuria in the general population resulted in a large response and a number of newly detected diseases. However, we found a very high percentage of positive testers of which probably a large part is false positive. Furthermore, only a small part of the positive testers visited a GP for additional examination and/or treatment. The efficiency of such a campaign could be increased by embedding the testing in health care to reduce the number of false-positive results and to ensure follow-up and treatment in case of a positive test result.
authors.affiliation: NIVEL (Netherlands Institute for Health Services Research), Utrecht, The Netherlands. m.nielen@nivel.nl
authors.forename: Markus M J
authors.initials: MM
authors.lastname: Nielen
authors.forename: François G
authors.initials: FG
authors.lastname: Schellevis
authors.forename: Robert A
authors.initials: RA
authors.lastname: Verheij
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000419:Albuminuria / Q000175:diagnosis*; D003430:Cross-Sectional Studies; D003920:Diabetes Mellitus; D005189:False Positive Reactions; D005260:Female; D058006:General Practice; D006801:Humans; D006973:Hypertension; D008297:Male; D008403:Mass Screening / Q000295:instrumentation* / Q000706:statistics & numerical data; D008875:Middle Aged; D009426:Netherlands; D011933:Reagent Kits, Diagnostic; D012307:Risk Factors; D012648:Self Care / Q000295:instrumentation*; D055815:Young Adult
chemical_list: D011933:Reagent Kits, Diagnostic