title: Smartphone-Based Urine Reagent Strip Test in the Emergency Department.
abstract: Although a smartphone could be used for a urine reagent strip test, few studies have reported on the reliability of the test in a clinical setting. The objective of our study was to access the smartphone-based urine reagent strip test in the clinical emergency department (ED).
  
  
  
  We developed a smartphone-based urine reagent strip reader for a rapid and accurate screening of leukocyte esterase (LE) and nitrite (NIT) in urine. The developed reader was evaluated with the clinical urine samples (n = 81). The detection performance of the reader for LE and NIT was evaluated to assess reliability of the reader; turnaround times (TATs) for analysis and the time for the entire study procedure were also calculated to assess the efficiency of the reader. A photometric analyzer (model US-3100R Plus(®); Eiken Chemical, Ltd., Tokyo, Japan) was used as a reference.
  
  
  
  The proposed reader showed high accuracy (85.2% for LE and 97.5% for NIT), exhibiting close agreement with the true values (κ = 0.903 for LE; κ = 1.000 for NIT). The reader also exhibited a lower median TAT for analysis than the photometric analyzer (3.0 min versus 33.0 min; p < 0.001). This reduction of TAT in the reader was even more evident considering the required time for delivery of urine samples for the photometric analyzer (3.0 min versus 62.0 min; p < 0.001).
  
  
  
  Our results demonstrated the clinical capability of a smartphone-based urine reagent strip test, and this reader is expected to enable a more rapid and reliable colorimetric test for screening of LE and NIT at the clinical setting and the point of care.
authors.affiliation: 1 Interdisciplinary Program in Bioengineering, Seoul National University Graduate School , Seoul, Republic of Korea.
authors.forename: Karam
authors.initials: K
authors.lastname: Choi
authors.affiliation: 2 Department of Emergency Medicine, Seoul National University Hospital , Seoul, Republic of Korea.
authors.forename: Ikwan
authors.initials: I
authors.lastname: Chang
authors.affiliation: 3 Department of Biomedical Engineering, Seoul National University College of Medicine , Seoul, Republic of Korea.|4 Institute of Medical & Biological Engineering, Medical Research Center, Seoul National University , Seoul, Republic of Korea.|5 Department of Biomedical Engineering, Seoul National University Hospital , Seoul, Republic of Korea.
authors.forename: Jung Chan
authors.initials: JC
authors.lastname: Lee
authors.affiliation: 2 Department of Emergency Medicine, Seoul National University Hospital , Seoul, Republic of Korea.
authors.forename: Do Kyun
authors.initials: do K
authors.lastname: Kim
authors.affiliation: 1 Interdisciplinary Program in Bioengineering, Seoul National University Graduate School , Seoul, Republic of Korea.
authors.forename: Seungwoo
authors.initials: S
authors.lastname: Noh
authors.affiliation: 2 Department of Emergency Medicine, Seoul National University Hospital , Seoul, Republic of Korea.
authors.forename: Heejeong
authors.initials: H
authors.lastname: Ahn
authors.affiliation: 6 Department of Emergency Medicine, Kangwon National University Hospital , Seoul, Republic of Korea.
authors.forename: Jun Hwi
authors.initials: JH
authors.lastname: Cho
authors.affiliation: 2 Department of Emergency Medicine, Seoul National University Hospital , Seoul, Republic of Korea.
authors.forename: Young Ho
authors.initials: YH
authors.lastname: Kwak
authors.affiliation: 3 Department of Biomedical Engineering, Seoul National University College of Medicine , Seoul, Republic of Korea.|4 Institute of Medical & Biological Engineering, Medical Research Center, Seoul National University , Seoul, Republic of Korea.|5 Department of Biomedical Engineering, Seoul National University Hospital , Seoul, Republic of Korea.
authors.forename: Sungwan
authors.initials: S
authors.lastname: Kim
authors.affiliation: 3 Department of Biomedical Engineering, Seoul National University College of Medicine , Seoul, Republic of Korea.|4 Institute of Medical & Biological Engineering, Medical Research Center, Seoul National University , Seoul, Republic of Korea.|5 Department of Biomedical Engineering, Seoul National University Hospital , Seoul, Republic of Korea.
authors.forename: Hee Chan
authors.initials: HC
authors.lastname: Kim
mesh_terms: D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D002265:Carboxylic Ester Hydrolases / Q000652:urine*; D004636:Emergency Service, Hospital / Q000458:organization & administration*; D005260:Female; D006801:Humans; D007564:Japan; D008297:Male; D008875:Middle Aged; D009573:Nitrites / Q000652:urine*; D011934:Reagent Strips; D015203:Reproducibility of Results; D000068997:Smartphone / Q000706:statistics & numerical data*
chemical_list: D009573:Nitrites; D011934:Reagent Strips; C021443:leukocyte esterase; D002265:Carboxylic Ester Hydrolases
keywords: bacteriuria; emergency department; image processing; leukocyte esterase; nitrite; pyuria; smartphone; urine