Smartphone-Based Urine Reagent Strip Test in the Emergency Department.

BACKGROUND Although a smartphone could be used for a urine reagent strip test, few studies have reported on the reliability of the test in a clinical setting. The objective of our study was to access the smartphone-based urine reagent strip test in the clinical emergency department (ED). MATERIALS AND METHODS We developed a smartphone-based urine reagent strip reader for a rapid and accurate screening of leukocyte esterase (LE) and nitrite (NIT) in urine. The developed reader was evaluated with the clinical urine samples (n = 81). The detection performance of the reader for LE and NIT was evaluated to assess reliability of the reader; turnaround times (TATs) for analysis and the time for the entire study procedure were also calculated to assess the efficiency of the reader. A photometric analyzer (model US-3100R Plus(®); Eiken Chemical, Ltd., Tokyo, Japan) was used as a reference. RESULTS The proposed reader showed high accuracy (85.2% for LE and 97.5% for NIT), exhibiting close agreement with the true values (κ = 0.903 for LE; κ = 1.000 for NIT). The reader also exhibited a lower median TAT for analysis than the photometric analyzer (3.0 min versus 33.0 min; p < 0.001). This reduction of TAT in the reader was even more evident considering the required time for delivery of urine samples for the photometric analyzer (3.0 min versus 62.0 min; p < 0.001). CONCLUSIONS Our results demonstrated the clinical capability of a smartphone-based urine reagent strip test, and this reader is expected to enable a more rapid and reliable colorimetric test for screening of LE and NIT at the clinical setting and the point of care.

[1]  J. R. Landis,et al.  The measurement of observer agreement for categorical data. , 1977, Biometrics.

[2]  Puneet Bhargava,et al.  Radiology education 2.0--on the cusp of change: part 2. eBooks; file sharing and synchronization tools; websites/teaching files; reference management tools and note taking applications. , 2013, Academic radiology.

[3]  C. Byington,et al.  Management of the non-toxic-appearing acutely febrile child: a 21st century approach. , 2011, The Journal of pediatrics.

[4]  D. Guzick,et al.  Utility of urine reagent strip in screening women with incontinence for urinary tract infection , 2004, International Urogynecology Journal.

[5]  Tamara A Katy,et al.  Pediatric urinary tract infections. , 2011, Emergency medicine clinics of North America.

[6]  P. Mahajan,et al.  Evaluation of child with fever without source: review of literature and update. , 2013, Pediatric clinics of North America.

[7]  Ali K. Yetisen,et al.  A smartphone algorithm with inter-phone repeatability for the analysis of colorimetric tests , 2014 .

[8]  G. Whitesides,et al.  Simple telemedicine for developing regions: camera phones and paper-based microfluidic devices for real-time, off-site diagnosis. , 2008, Analytical chemistry.

[9]  Li Shen,et al.  Point-of-care colorimetric detection with a smartphone. , 2012, Lab on a chip.

[10]  D. Church,et al.  Evaluation of the Leukocyte Esterase and Nitrite Urine Dipstick Screening Tests for Detection of Bacteriuria in Women with Suspected Uncomplicated Urinary Tract Infections , 1999, Journal of Clinical Microbiology.

[11]  Getenet Beyene,et al.  Diagnostic accuracy of rapid urine dipstick test to predict urinary tract infection among pregnant women in Felege Hiwot Referral Hospital, Bahir Dar, North West Ethiopia , 2014, BMC Research Notes.

[12]  Je-Kyun Park,et al.  A simple and smart telemedicine device for developing regions: a pocket-sized colorimetric reader. , 2011, Lab on a chip.

[13]  Jong Il Hong,et al.  Development of the smartphone-based colorimetry for multi-analyte sensing arrays. , 2014, Lab on a chip.

[14]  Aydogan Ozcan,et al.  Albumin testing in urine using a smart-phone. , 2013, Lab on a chip.

[15]  W. Qiu,et al.  Integration of cell phone imaging with microchip ELISA to detect ovarian cancer HE4 biomarker in urine at the point-of-care. , 2011, Lab on a chip.

[16]  Eric W. Glissmeyer,et al.  Dipstick Screening for Urinary Tract Infection in Febrile Infants , 2014, Pediatrics.

[17]  Tehmina Munir,et al.  Comparison of urine dipstick test with conventional urine culture in diagnosis of urinary tract infection. , 2015, Journal of the College of Physicians and Surgeons--Pakistan : JCPSP.

[18]  K. Roberts.  Urinary Tract Infection: Clinical Practice Guideline for the Diagnosis and Management of the Initial UTI in Febrile Infants and Children 2 to 24 Months , 2011, Pediatrics.