title: The Italian External Quality Assessment (EQA) program on urinary sediment: results of the period 2012-2015.
abstract: BACKGROUND
  Manual microscopy still represents the gold standard for urinary sediment (US) examination. We report the results obtained in the period 2012-2015 by the EQA Italian program on US, which today involves about 260 laboratories.
  
  
  METHODS
  The program includes four surveys per year. In two surveys, participants are asked to supply identification and clinical association of US particles. In two other surveys, they are asked to supply the diagnosis of clinical cases, presented with images, some key laboratory findings and a short clinical history. Sixty-six images of US particles (21 cells, 2 lipids, 21 casts, 10 crystals, 3 microorganisms, 15 contaminants) and seven clinical cases were presented.
  
  
  RESULTS
  The correct identification rate for each category of particles, in decreasing order, was: micro-organisms (mean±SD: 92.4%±4.5%), lipids (92.0%±1.8%), casts (82.8%±8.8%), crystals (79.4%±29.8%), cells (77.3%±13.5%), and contaminants (70.9%±22.2%). For 13 particles, a correct clinical association was indicated by 91.5%±11.7% of participants, while it was 52.7% for particles associated with urinary tract infection. For clinical cases, due to a high rate of particles misidentification, only 44.3%±10.1% of participants achieved access to clinical diagnosis, which was then correctly indicated by 92.5%±5.3% of them.
  
  
  CONCLUSIONS
  The results of the EQA program confirm that, while some US particles are well known in terms of identification, clinical association and clinical meaning, others particles still are not, and this represents an important reason to encourage EQA programs on US.
authors.forename: Sandra
authors.initials: S
authors.lastname: Secchiero
authors.forename: Giovanni B
authors.initials: GB
authors.lastname: Fogazzi
authors.forename: Fabio
authors.initials: F
authors.lastname: Manoni
authors.forename: MariaGrazia
authors.initials: M
authors.lastname: Epifani
authors.forename: Giuseppe
authors.initials: G
authors.lastname: Garigali
authors.forename: Mario
authors.identifier: http://orcid.org/0000-0002-0270-1711
authors.initials: M
authors.lastname: Plebani
mesh_terms: D006801:Humans; D007558:Italy; D007753:Laboratories / Q000592:standards; D008853:Microscopy / Q000379:methods / Q000592:standards*; D011786:Quality Control; D011795:Surveys and Questionnaires; D016482:Urinalysis / Q000379:methods* / Q000592:standards