Clinical effectiveness of point of care tests for diagnosing urinary tract infection: a systematic review
Abstract
BACKGROUND
Point of care tests (POCT) have the potential to improve the urinary tract infection (UTI) diagnostic pathway, as they can provide a diagnosis quickly in near-patient settings, and some also identify causative pathogens/antimicrobial sensitivity.
OBJECTIVES
To assess the clinical impact, accuracy, and technical characteristics of POCT for diagnosing UTI.
METHODS DATA SOURCES
Five electronic databases, two clinical trials registries, study reports and review reference lists, and websites.
STUDY ELIGIBILITY CRITERIA
Randomised controlled trials/non-randomised studies and diagnostic test accuracy studies published since 2000.
PARTICIPANTS
People with suspected UTI.
TESTS
Rapid tests (results <40 mins): Astrego PA-100 system, Lodestar DX, Uriscreen, UTRiPLEX. Culture tests (results <24 hours): Flexicult Human, ID Flexicult, Diaslide, Dipstreak, Chromostreak, Uricult, Uricult Trio, Uricult Plus.
REFERENCE STANDARD
Any.
ASSESSMENT OF RISK OF BIAS
Risk of Bias-2, QUADAS-2, QUADAS-C.
METHOD OF DATA SYNTHESIS
Narrative summary and bivariate random effects meta-analyses to estimate summary sensitivity and specificity.
RESULTS
Two RCTs evaluated Flexicult Human (one against standard care; one against ID Flexicult). No difference was reported in antibiotic use concordant with culture results (OR 0.84 95% CI 0.58-1.20) or appropriate antibiotic prescribing (OR 1.44 95% CI 1.03-1.99). Initial antibiotic prescribing was lower with Flexicult than standard care (OR 0.56 95% CI…
How strong is the evidence?
Evidence Hub reads this as a systematic review, done in people. Its evidence level is 1 of 5 (Highest · pooled evidence). Pooled evidence from several studies sits at the top of the evidence pyramid.
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