title: Analytical performance, agreement and user-friendliness of six point-of-care testing urine analysers for urinary tract infection in general practice.
abstract: OBJECTIVE
  Various point-of-care testing (POCT) urine analysers are commercially available for routine urine analysis in general practice. The present study compares analytical performance, agreement and user-friendliness of six different POCT urine analysers for diagnosing urinary tract infection in general practice.
  
  
  METHODS
  All testing procedures were performed at a diagnostic centre for primary care in the Netherlands. Urine samples were collected at four general practices.
  
  
  METHODS
  Analytical performance and agreement of the POCT analysers regarding nitrite, leucocytes and erythrocytes, with the laboratory reference standard, was the primary outcome measure, and analysed by calculating sensitivity, specificity, positive and negative predictive value, and Cohen's κ coefficient for agreement. Secondary outcome measures were the user-friendliness of the POCT analysers, in addition to other characteristics of the analysers.
  
  
  RESULTS
  The following six POCT analysers were evaluated: Uryxxon Relax (Macherey Nagel), Urisys 1100 (Roche), Clinitek Status (Siemens), Aution 11 (Menarini), Aution Micro (Menarini) and Urilyzer (Analyticon). Analytical performance was good for all analysers. Compared with laboratory reference standards, overall agreement was good, but differed per parameter and per analyser. Concerning the nitrite test, the most important test for clinical practice, all but one showed perfect agreement with the laboratory standard. For leucocytes and erythrocytes specificity was high, but sensitivity was considerably lower. Agreement for leucocytes varied between good to very good, and for the erythrocyte test between fair and good. First-time users indicated that the analysers were easy to use. They expected higher productivity and accuracy when using these analysers in daily practice.
  
  
  CONCLUSIONS
  The overall performance and user-friendliness of all six commercially available POCT urine analysers was sufficient to justify routine use in suspected urinary tract infections in general practice.
authors.affiliation: University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands.
authors.forename: Marjolein J C
authors.initials: MJ
authors.lastname: Schot
authors.affiliation: Saltro, Diagnostic Center for Primary Care, Utrecht, The Netherlands.
authors.forename: Sanne
authors.initials: S
authors.lastname: van Delft
authors.affiliation: Saltro, Diagnostic Center for Primary Care, Utrecht, The Netherlands.
authors.forename: Antoinette M J
authors.initials: AM
authors.lastname: Kooijman-Buiting
authors.affiliation: University Medical Center Utrecht, Julius Center for Health Sciences and Primary Care, Utrecht, The Netherlands.
authors.forename: Niek J
authors.initials: NJ
authors.lastname: de Wit
authors.affiliation: Saltro, Diagnostic Center for Primary Care, Utrecht, The Netherlands.
authors.forename: Rogier M
authors.initials: RM
authors.lastname: Hopstaken
mesh_terms: D003955:Diagnostic Tests, Routine; D058006:General Practice; D006801:Humans; D009426:Netherlands / Q000453:epidemiology; D019095:Point-of-Care Systems; D000067716:Point-of-Care Testing; D015203:Reproducibility of Results; D014552:Urinary Tract Infections / Q000175:diagnosis*
keywords: GENERAL MEDICINE (see Internal Medicine); PRIMARY CARE