title: Urinary dipstick proteinuria testing: does automated strip analysis offer an advantage over visual testing?
abstract: OBJECTIVE
  To compare the diagnostic test properties of automated and visually read urine dipstick screening for detection of a random protein:creatinine ratio (PrCr) ≥ 30 mg/mmol.
  
  
  METHODS
  Urine samples were collected prospectively from 160 women attending high-risk maternity clinics at a tertiary care facility. Samples were divided into two aliquots; one aliquot was tested using two different urine test strips, one read visually and one by an automated reader. A second aliquot of the same urine was analyzed for urinary protein and creatinine. Performance of visual and automated dipstick results (proteinuria ≥ 1+) were compared for detection of PrCr ≥ 30 mg/mmol using non-dilute urine samples (urinary creatinine ≥ 3 mmol/L).
  
  
  RESULTS
  Both urine test strips showed low sensitivity (visual 56.0% and automated 53.8%). Positive likelihood ratios were 15.0 for visual dipstick testing (95% CI 5.9 to 37.9) and 24.6 for automated (95% CI 7.6 to 79.6). Negative likelihood ratios were 0.46 for visual dipstick testing (95% CI 0.29 to 0.71) and 0.47 for automated (95% CI 0.31 to 0.72).
  
  
  CONCLUSIONS
  Automated dipstick testing was not superior to visual testing for detection of proteinuria in pregnant women in a primarily outpatient setting. Sensitivity may depend on the test strips and/or analyzer used.
authors.affiliation: Department of Pathology and Laboratory Medicine, Children's and Women's Health Centre of British Columbia and the University of British Columbia, Vancouver BC; Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC.
authors.forename: Dane A
authors.initials: DA
authors.lastname: De Silva
authors.affiliation: Department of Pathology and Laboratory Medicine, Children's and Women's Health Centre of British Columbia and the University of British Columbia, Vancouver BC.
authors.forename: Anne C
authors.initials: AC
authors.lastname: Halstead
authors.affiliation: Department of Medicine, Université de Sherbrooke, Sherbrooke QC.
authors.forename: Anne-Marie
authors.initials: AM
authors.lastname: Côté
authors.affiliation: Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC.
authors.forename: Yasser
authors.initials: Y
authors.lastname: Sabr
authors.affiliation: Department of Obstetrics and Gynaecology, University of British Columbia, Vancouver BC; Child and Family Research Institute, University of British Columbia, Vancouver BC.
authors.forename: Peter
authors.initials: P
authors.lastname: von Dadelszen
authors.affiliation: Child and Family Research Institute, University of British Columbia, Vancouver BC; Department of Medicine, University of British Columbia, Vancouver BC; Department of Specialized Women's Health, British Columbia Women's Hospital and Health Centre, Vancouver BC.
authors.forename: Laura A
authors.initials: LA
authors.lastname: Magee
mesh_terms: D000328:Adult; D001331:Automation; D003404:Creatinine / Q000652:urine; D005260:Female; D006801:Humans; D011247:Pregnancy; D011248:Pregnancy Complications / Q000175:diagnosis* / Q000652:urine*; D011446:Prospective Studies; D011507:Proteinuria / Q000175:diagnosis* / Q000652:urine*; D016482:Urinalysis / Q000379:methods
chemical_list: D003404:Creatinine
keywords: automated; pregnancy; proteinuria; urinary dipstick testing; visual