Emergency physicians versus laboratory technicians: are the urinalysis andmicroscopy results comparable? A pilot study

In the literature to date, there are no studies that directly evaluate micr oscopic urine examination results obtained by a physician compared to those of a trained laboratory technician. Our purpose in undertaking this study was to determine whether there would be comparable results obtained by thes e two groups. The study took place in an Emergency Medicine Department with 45,000 visits annually, Each urine sample obtained on patients presenting to the Emergency Department was divided into two lots: one was sent to the laboratory and the other was analyzed by the emergency physician. A compari son of both dipstick and microscopic results by physician and laboratory st aff was then made using sensitivity, specificity, and Kappa analysis. Stati stical analysis of the data revealed close agreement between the emergency physician and laboratory technician with respect to the following component s of urinalysis: red blood cell urinalysis and microscopy, leukocyte estera se, and nitrite testing, Microscopy for white cells and bacteria and testin g for proteinuria were not in close agreement. Urinalysis by emergency phys icians is comparable to laboratory technicians for a number of the testing components. However, in this limited pilot study, emergency physicians were not able to consistently perform urinalysis for the laboratory standard. ( C) 1999 Elsevier Science Inc.