Female patient self-diagnosis compared with emergency physician diagnosis of urinary tract infection.
BACKGROUND
Urinary tract infection (UTI) is a common emergency department (ED) complaint and self-diagnosis may be possible.


OBJECTIVE
The objective was to compare female patient self-diagnosis compared with emergency physician (EP) diagnosis of UTI.


METHODS
This was a prospective cohort study in a single urban ED. Women aged 18-64 years with a chief complaint of UTI, urinary frequency, or dysuria who presented to an urban academic ED were enrolled in a convenience sample fashion. Patients completed a written four-question survey by an ED greeter before triage. Charts of respondents were reviewed for demographic, laboratory, and EP diagnosis.


RESULTS
Fifty women were enrolled; 100% of patients who were approached participated in the study. Mean age was 33.7 years (standard deviation 13.8). Forty-three patients (86%) had a history of UTI. Forty-one patients (82%) thought they had a UTI on the index visit. Thirty patients (60%) preferred to buy over-the-counter antibiotics for their symptoms instead of seeing a doctor. Fifteen patients (30%) identified a specific antibiotic they would take. Of the 41 patients who thought they had a UTI, 25 (61%) were given that diagnosis. Of the 30 patients who would have preferred over-the-counter antibiotics, 20 (67%) were actually prescribed them. Agreement between EP and women's final impressions was low (κ = 0.11).


CONCLUSIONS
There was poor agreement between EP diagnosis and self-diagnosis of UTI. In our ED population, women should be encouraged to seek medical attention to confirm the diagnosis.
Department of Emergency Medicine, Kent Hospital, Warwick, Rhode Island.
Jill C
JC
Donofrio
Scott G
SG
Weiner
D000293:Adolescent; D000328:Adult; D003951:Diagnostic Errors / Q000706:statistics & numerical data; D059026:Diagnostic Self Evaluation; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008875:Middle Aged; D016017:Odds Ratio; D010865:Pilot Projects; D011446:Prospective Studies; D012680:Sensitivity and Specificity; D014481:United States; D014552:Urinary Tract Infections / Q000175:diagnosis*; D055815:Young Adult
self-diagnosis; urinary tract infection