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Vuljanić D, Dojder A, Špoljarić V, Saračević A, Dukić L, Leniček-Krleža J, Vlašić-Tanasković J, Maradin I, Grzunov A, Vogrinc Ž, Šimundić AM. Analytical verification of 12 most commonly used urine dipsticks in Croatia: comparability, repeatability and accuracy. Biochem Med (Zagreb) 2019; 29:010708. [PMID: 30799977 PMCID: PMC6366948 DOI: 10.11613/bm.2019.010708] [Citation(s) in RCA: 22] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/26/2018] [Accepted: 12/28/2018] [Indexed: 11/01/2022] Open
Abstract
Introduction Variability among manufacturers of urine dipsticks, respective to their accuracy and measurement range, may lead to diagnostic errors and thus create a serious risk for the patient. Our aims were to determine the level of agreement between 12 most commonly used urine dipsticks in Croatia, examine their accuracy for glucose and total protein and to test their repeatability. Materials and methods A total of 75 urine samples were used to examine comparability and accuracy of 12 dipstick brands (Combur 10 TestM, ChoiceLine 10, Combur 10 TestUX, ComboStik 10M, ComboStik 11M, CombiScreen 11SYS, CombiScreen 10SL, Combina 13, Combina 11S, Combina 10M, UriGnost 11, Multistix 10SG). Agreement between each dipstick and the reference (Combur 10 TestM) was expressed as kappa coefficient (acceptable κ ≥ 0.80). Accuracy for glucose and total protein was tested by comparison with quantitative measurements on analysers: AU400 (Beckman Coulter, USA), Cobas 6000 c501 (Roche Diagnostics, Germany) and Architect plus c4000 (Abbott, USA). Repeatability was assessed on 20 replicates (acceptable > 90%). Results Best agreement was achieved for glucose, total protein and nitrite (11/11, k > 0.80) and the lowest for bilirubin (5/5, k < 0.60). Sensitivities for total protein were 41-75% (AU400) and 56-92% (Cobas and Architect); while specificities were 41-75% (AU400, Cobas, Architect). Dipsticks' sensitivity and specificity for glucose were 68-98%. Most of the dipsticks showed unacceptable repeatability (6/12, < 90%) for one parameter, most prominently for pH (3/12, < 90%). Conclusions Most commonly used dipsticks in Croatia showed low level of agreement between each other. Moreover, their repeatability varies among manufacturers and their accuracy for glucose and proteins is poor.
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Affiliation(s)
- Dora Vuljanić
- Department of Medical Laboratory Diagnostics, University Hospital "Sveti Duh", Zagreb, Croatia
| | - Ana Dojder
- Department of Medical Laboratory Diagnostics, University Hospital "Sveti Duh", Zagreb, Croatia
| | - Valentina Špoljarić
- Department of Medical Laboratory Diagnostics, University Hospital "Sveti Duh", Zagreb, Croatia
| | - Andrea Saračević
- Department of Medical Laboratory Diagnostics, University Hospital "Sveti Duh", Zagreb, Croatia
| | - Lora Dukić
- Department of Medical Laboratory Diagnostics, University Hospital "Sveti Duh", Zagreb, Croatia
| | - Jasna Leniček-Krleža
- Department of Laboratory Diagnostics, Children's Hospital Zagreb, Zagreb, Croatia.,Croatian Centre for Quality Assessment in Laboratory Medicine (CROQALM), Croatian Society of Medical Biochemistry and
Laboratory Medicine, Zagreb, Croatia
| | - Jelena Vlašić-Tanasković
- Department of Laboratory Diagnostics, General Hospital Pula, Pula, Croatia.,Croatian Centre for Quality Assessment in Laboratory Medicine (CROQALM), Croatian Society of Medical Biochemistry and
Laboratory Medicine, Zagreb, Croatia
| | - Ivana Maradin
- Medical - biochemistry Laboratory: "Mirjana Plavetić and Ivana Maradin", Karlovac, Croatia.,Croatian Centre for Quality Assessment in Laboratory Medicine (CROQALM), Croatian Society of Medical Biochemistry and
Laboratory Medicine, Zagreb, Croatia
| | - Ana Grzunov
- Department of Laboratory Diagnostics, Children's Hospital Zagreb, Zagreb, Croatia.,Croatian Centre for Quality Assessment in Laboratory Medicine (CROQALM), Croatian Society of Medical Biochemistry and
Laboratory Medicine, Zagreb, Croatia
| | - Željka Vogrinc
- Department of Laboratory Diagnostics, University Hospital Centre Zagreb, Zagreb, Croatia
| | - Ana-Maria Šimundić
- Department of Medical Laboratory Diagnostics, University Hospital "Sveti Duh", Zagreb, Croatia
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Abstract
PURPOSE The aim of this study was to compare the reliability of the methods conventionally used to identify low levels of blood contamination in human follicular fluid (hFF) as applicable in the clinical environment. METHODS Follicular fluid (n = 339) and plasma samples (n = 20) were collected from patients (n = 138) attending the Centre for Fertility Studies, HF Verwoerd Hospital, University of Pretoria, South Africa. hFF blood contamination was assessed by means of (a) visual inspection, (b) hematocrit (Hct), (c) spectrophotometric analysis, (d) spectrophotometric hemoglobin kit, and (e) Combur-9-test urine sticks. RESULTS (1) Neither hematocrit nor spectrophotometry provided reliable detection at low levels of blood contamination. (2) Visual inspection presented with a better discriminatory ability than either Hct or spectrophotometry. (3) Combur-9-test sticks identified up to 50% of blood-contaminated fluids. (4) Spectrophotometrically determined hemoglobin levels presented with weak discriminatory abilities for detecting blood-contaminated fluids. CONCLUSIONS Visual inspection as performed in this study provides a fast and relatively reliable method for the determination of blood-contaminated hFFs. In a laboratory environment, however, it would be recommended that a combination of visual inspection, Hct, and spectrophotometric evaluation be employed for the selection of blood-free fluids.
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Affiliation(s)
- P F Levay
- Department of Obstetrics and Gynaecology, University of Pretoria, Republic of South Africa
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