Wigton R S, Hoellerich V L, Ornato J P, Leu V, Mazzotta L A, Cheng I H
Arch Intern Med. 1985 Dec;145(12):2222-7.
To develop a decision rule for predicting urinary culture results in patients suspected of having urinary tract infection, we used discriminant analysis to identify the optimum combination of clinical findings. Thirty variables identified in a pilot study were recorded from 248 patients in a second study. Five findings were independent predictors of positive urinary culture: history of urinary tract infection, back pain, microscopic pyuria, hematuria, and bacteriuria. An additive decision rule that assigned one point for each of the five variables was tested in a third group of 258 patients. These scores stratified patients into subsets with increasing likelihood of positive culture. Higher scores identified patients who can confidently be treated without documentation of bacteriuria. If the rule applies successfully to other populations, cost savings could result from identification of patients who do not require quantitative urinary culture to demonstrate significant bacteriuria.
为制定一项用于预测疑似尿路感染患者尿培养结果的决策规则，我们采用判别分析来确定临床发现的最佳组合。在第二项研究中，记录了来自248名患者的初步研究中确定的30个变量。五个发现是尿培养阳性的独立预测因素：尿路感染史、背痛、镜下脓尿、血尿和菌尿。在第三组258名患者中测试了一项加法决策规则，该规则为五个变量中的每一个赋予一分。这些分数将患者分层为尿培养阳性可能性增加的亚组。较高的分数识别出那些无需细菌尿记录即可放心治疗的患者。如果该规则成功应用于其他人群，通过识别那些无需定量尿培养来证明显著细菌尿的患者，可能会节省成本。
