Medical Director, Sanz Medical Center, Laniado Hospital, Netanya, Israel.
Clinical Utility Department, Sanz Medical Center, Laniado Hospital, Netanya and School of Public, Health, University of Tel Aviv, Tel Aviv, Israel.
J Eval Clin Pract. 2022 Aug;28(4):566-568. doi: 10.1111/jep.13638. Epub 2021 Nov 23.
Restricting the performance of microscopic urinalyses only to patients in whom it was specifically requested has been shown to reduce their number in laboratories servicing both inpatients and outpatients.
To determine the effect of such restriction solely in in-patients in a 400-bed regional hospital.
In 2017, we discontinued routine ('reflex') microscopic urinalysis for all positive dipstick results, and restricted such testing to in-patients in whom it was specifically requested by a doctor. We compared the numbers of patients in three internal medicine departments who had a urinalysis over 2-year periods before and after 2017, and reviewed doctors' complaints.
Before 2017, more than 80% of all dipstick tested samples had one or more abnormalities that led to a microscopic examination. Discontinuation of reflex microscopy reduced microscopic urinalysis to less than 10% of all patients with dipsticks on admission. Requests for repeat urinalysis decreased from 4.3% to 2.5% and there were no complaints after the change in policy.
Discontinuation of a 'reflex' microscopic urinalysis in patients with abnormal dipstick results did not increase repeat urine testing. Doctors apparently felt that the microscopic urinalysis does not have clinical utility in the vast majority of hospitalized adult patients.
将显微镜尿液分析的检测仅限制在有特定需求的患者中，已被证明可以减少住院和门诊患者实验室中的检测数量。
仅在一家 400 床位的地区医院的住院患者中确定这种限制的效果。
2017 年，我们停止了所有阳性尿液试纸结果的常规（“反射性”）显微镜尿液分析，并将此类检测仅限于医生特别要求的住院患者。我们比较了 2017 年前后两年间三个内科病房接受尿液分析的患者数量，并审查了医生的投诉。
在 2017 年之前，超过 80%的所有接受过尿液试纸检测的样本都有一个或多个异常，需要进行显微镜检查。停止反射性显微镜检查后，将入院时尿液试纸异常的患者中的显微镜尿液分析减少到不足 10%。重复尿液检测的请求从 4.3%下降到 2.5%，并且在政策改变后没有投诉。
在尿液试纸异常的患者中停止“反射性”显微镜尿液分析不会增加重复尿液检测。医生显然认为，在绝大多数住院成年患者中，显微镜尿液分析没有临床意义。
