What is the predictive value of urinary symptoms for diagnosing urinary tract infection in women?

Abstract:

OBJECTIVES:Our aim was to determine the probability of correctly diagnosing urinary tract infections (UTIs) from urinary symptoms and signs, studying their sensitivity, specificity and likelihood ratio (LR) when clinical history, signs and reactive strip test results are taken into account. METHODS:An epidemiological analysis with a diagnostic and clinical orientation was carried out in a primary health care setting. The subjects comprised 343 women > or =14 years of age who consulted their family physician for incident urinary tract symptoms. A guided medical examination was carried out using a check-list formulary, reactive strip test, urine culture and the clinical course of all patients. RESULTS:The pre-test probability of having UTI among patients with incident urinary symptoms is 0.484 [95% confidence interval (CI) 0.431-0.536]. Positive LRs for UTI are: painful voiding 1.31 (95% CI 1.12-1.54), urgency 1.29 (95% CI 1.12-1.50), urinary frequency 1.16 (95% CI 1.06-1.28) and tenesmus 1.16 (95% CI 1.02-1.32). The probability of UTI is reduced by the presence of genital discomfort, dyspareunia, vaginal discharge, positive lumbar fist percussion and perineal discomfort. Nitrites on the urine reactive strip test increase the probability of UTI by >5 times, moderate pyuria increases it by >1.5 times, and the presence of both findings does so by >7 times. CONCLUSIONS:In women with urinary symptoms, a thorough clinical examination, together with performance of a reactive strip test during the office visit, improves the chances of detecting UTI.

journal_name

Fam Pract

journal_title

Family practice

authors

Medina-Bombardó D,Seguí-Díaz M,Roca-Fusalba C,Llobera J,dysuria team.

doi

10.1093/fampra/20.2.103

subject

Has Abstract

pub_date

2003-04-01 00:00:00

pages

103-7

issue

2

eissn

0263-2136

issn

1460-2229

journal_volume

20

pub_type

杂志文章
  • Sources of information about new drugs and attitudes towards drug prescribing: an international study of differences between primary care physicians.

    abstract::Doctors in different countries completed a questionnaire relating to the importance they attributed to eight possible sources of information about a new drug, their estimation of patients' expectations of the doctor prescribing drugs under specific circumstances and their therapeutic response to common clinical genera...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/4.2.123

    authors: Hull FM,Marshall T

    更新日期:1987-06-01 00:00:00

  • Incidence, patient characteristics and treatment initiated for GP-diagnosed depression in general practice: results of a 1-year nationwide surveillance study.

    abstract:BACKGROUND:Despite its public health significance, data about depression in general practice are often unavailable. OBJECTIVE:To study (i) the incidence of GP-diagnosed depression during 2008, (ii) associations between patient characteristics, appraised severity and initiated treatment, (iii) GPs' usual care compared ...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cms024

    authors: Boffin N,Bossuyt N,Declercq T,Vanthomme K,Van Casteren V

    更新日期:2012-12-01 00:00:00

  • Societal perspectives on over-the-counter (OTC) medicines.

    abstract:BACKGROUND:Over-the-counter (OTC) medicines are increasingly used for self-medication, but such products can be misused/abused. OBJECTIVES:The aim of this study was to investigate the general public's opinion and perceptions of OTC medicines, including the misuse/abuse of such preparations. METHODS:Data were collecte...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmh723

    authors: Wazaify M,Shields E,Hughes CM,McElnay JC

    更新日期:2005-04-01 00:00:00

  • Reflections from organization science on the development of primary health care research networks.

    abstract::In the UK, policy changes in primary health care research and development have led to the establishment of primary care research networks. These organizations aim to increase research culture, capacity and evidence base in primary care. As publicly funded bodies, these networks need to be accountable. Organizational s...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/18.5.540

    authors: Fenton E,Harvey J,Griffiths F,Wild A,Sturt J

    更新日期:2001-10-01 00:00:00

  • Organizing palliative care for rural populations: a systematic review of the evidence.

    abstract:BACKGROUND:Palliative care services have developed mostly in urban areas. Rural areas typically are characterized by the lack of well-organized services, with primary care professionals, specifically GPs and community nurses, having to undertake most of the palliative care. Little is known, however, either of their vie...

    journal_title:Family practice

    pub_type: 杂志文章,评审

    doi:10.1093/fampra/cmg312

    authors: Evans R,Stone D,Elwyn G

    更新日期:2003-06-01 00:00:00

  • Screening of depression in patients with chronic medical diseases in a primary care setting.

    abstract:BACKGROUND:Patients with chronic medical diseases may have depression that is not recognized by their primary care physicians. OBJECTIVES:We aimed to examine the application of Zung's Self-Rating Depression Scale (SDS) in the screening of depression in primary care patients with chronic medical diseases in a Chinese p...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/15.1.67

    authors: Leung KK,Lue BH,Lee MB,Tang LY

    更新日期:1998-02-01 00:00:00

  • Is COPD a rare disease? Prevalence and identification rates in smokers aged 40 years and over within general practice in Germany.

    abstract:BACKGROUND:According to literature, COPD rates are high in spite of decreasing rates of main risk factors smoking and air pollution in developed countries. general practice is a good place to survey unbiased prevalence rates. Ten studies done in general practice over the last 20 years found prevalence rates among smoke...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmn084

    authors: Gingter C,Wilm S,Abholz HH

    更新日期:2009-02-01 00:00:00

  • The effect of introduction of a guideline on the management of vaginal discharge and in particular bacterial vaginosis in primary care.

    abstract:BACKGROUND:Bacterial vaginosis (BV) is the commonest cause of vaginal discharge, and its association with obstetric and gynaecological complications is being recognized increasingly. It was our impression that BV was poorly understood and underdiagnosed in family practice. OBJECTIVE:The aim of this study was to explor...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/18.3.253

    authors: Langsford MJ,Dobbs FF,Morrison GM,Dance DA

    更新日期:2001-06-01 00:00:00

  • Who do we discharge from renal clinic and what does it mean for primary care?

    abstract:BACKGROUND:It is unclear whether discharging patients from renal clinic to primary care is safe. AIM:To determine the characteristics, primary care monitoring and renal outcomes of patients discharged from renal clinic. DESIGN AND SETTING:A retrospective study of 2236 adults discharged from a tertiary renal clinic be...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmz055

    authors: Pyart R,Lim S,Hussein B,Riley S,Roberts G

    更新日期:2020-03-25 00:00:00

  • What can doctors do to achieve a successful consultation? Videotaped interviews analysed by the 'consultation map' method.

    abstract::Positive consultations, where both the GP and the patient had a positive impression, were compared with negative consultations, where both the GP and the patient had a negative impression. The consultations were compared with respect to tasks listed by Pendelton et al. in their 'consultation map', constituting satisfy...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/9.1.61

    authors: Arborelius E,Bremberg S

    更新日期:1992-03-01 00:00:00

  • Availability and acceptance of health education among socially 'at risk' pregnant women attending health centres in Belfast.

    abstract::This study highlights the large number of pregnant women in Belfast who fall into the 'at risk' category based on socioeconomic factors and suggests a need for greater emphasis on health education by professionals in both the fields of health and education in order to improve the knowledge and change the attitudes and...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/3.2.85

    authors: McKnight A,Merrett JD

    更新日期:1986-06-01 00:00:00

  • Examination and communication: a study of first encounters between patients and physiotherapists.

    abstract::What happens in first encounters between patients and physiotherapists? Videotaped encounters between two patients and their physiotherapists were analysed in depth to try to answer this question. It is advocated that attention must not be restricted to either clinical decision making or communication, but needs to be...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/9.2.195

    authors: Thornquist E

    更新日期:1992-06-01 00:00:00

  • Comparison of health care utilization among users of public and private community health centres in urban China.

    abstract:BACKGROUND:In China, the government has encouraged the participation of private sector facilities in primary care to improve health care quality. OBJECTIVE:We compare health care utilization patterns among patients who select private versus public community health centres (CHCs) for reimbursed outpatient services. ME...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmaa058

    authors: Shen M,He W,Li L,Wu Y

    更新日期:2020-11-28 00:00:00

  • Supporting GPs whose performance gives cause for concern: the North Trent experience.

    abstract:BACKGROUND:The North Trent scheme to address the problem of GPs whose performance gives cause for concern was implemented in 1997. This paper describes the structure and process of the scheme and evaluates the main outcomes. METHODS:We used non-participant observation and semi-structured interviews with representative...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/18.2.123

    authors: Joesbury H,Mathers N,Lane P

    更新日期:2001-04-01 00:00:00

  • Patient characteristics do not predict the individual response to antihypertensive medication: a cross-over trial.

    abstract:Background:International guidelines on hypertension management do not agree on whether patient characteristics can be used for the first choice of treatment of uncomplicated essential hypertension. Objective:We wanted to identify predictive patient characteristics to the response of two different classes of antihypert...

    journal_title:Family practice

    pub_type: 杂志文章,多中心研究,随机对照试验

    doi:10.1093/fampra/cmx075

    authors: van der Wel MC,Biermans M,Akkermans R,Lenders JWM,van Weel C,Deinum J

    更新日期:2018-01-16 00:00:00

  • The BeweegKuur programme: a qualitative study of promoting and impeding factors for successful implementation of a primary health care lifestyle intervention for overweight and obese people.

    abstract:BACKGROUND:The aim of the study was to identify promoting and impeding factors for successful implementation of a Dutch primary health care-based lifestyle programme called 'BeweegKuur'. BeweegKuur aims to increase the physical activity and change the diet of people at increased health risk due to overweight or obesity...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmr056

    authors: Helmink JH,Kremers SP,Van Boekel LC,Van Brussel-Visser FN,Preller L,De Vries NK

    更新日期:2012-04-01 00:00:00

  • GPs' attitudes to minor ailments.

    abstract:BACKGROUND:It is generally considered that a significant proportion of 'inappropriate' demand for GP services is generated by consultations for minor ailments. How GPs manage minor ailments is likely to affect how patients perceive and handle similar illnesses in the future. Whilst this potentially has significant impl...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/18.6.581

    authors: Morris CJ,Cantrill JA,Weiss MC

    更新日期:2001-12-01 00:00:00

  • Drinking alcohol for medicinal purposes by people aged over 75: a community-based interview study.

    abstract:BACKGROUND:Physicians often encounter patients using alcohol as self-medication, but studies on community level are scarce. Because of alcohol-medicine interactions, it is important to know also all self-medication used. OBJECTIVE:To describe alcohol use as self-medication by people aged over 75 years. METHODS:The ho...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmn065

    authors: Aira M,Hartikainen S,Sulkava R

    更新日期:2008-12-01 00:00:00

  • A survey of Dutch GPs' attitudes towards help seeking and follow-up care for relatives bereaved by suicide.

    abstract:BACKGROUND:Relatives who are bereaved by suicide likely consult their GP when they feel the need for professional help. GPs may play a key role in establishing who is at risk for adverse consequences of the loss as they are familiar with relatives' possible psychiatric vulnerabilities. The availability of evidence-base...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmp046

    authors: de Groot M,van der Meer K,Burger H

    更新日期:2009-10-01 00:00:00

  • Presentation, antibiotic management and associated outcome in Polish adults presenting with acute cough/LRTI.

    abstract:OBJECTIVE:In-depth knowledge of existing practice is required to inform interventions aimed at antibiotic prescribing quality improvement. We set out to describe the presentation, antimicrobial management and associated outcome of adults presenting in general practice with acute cough/lower respiratory tract infection ...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmr019

    authors: Godycki-Cwirko M,Hood K,Nocun M,Muras M,Goossens H,Butler CC

    更新日期:2011-12-01 00:00:00

  • The incidence and characteristics of end-of-life decisions by GPs in Belgium.

    abstract:BACKGROUND:Medical end-of-life decisions (ELDs) have been discussed for several years in different countries, but little is known about the involvement of GPs in these ELDs. OBJECTIVES:The aim of the present study was to establish the incidence and characteristics of ELDs by GPs. METHOD:We selected 3999 deaths, a 20%...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmh312

    authors: Bilsen J,Stichele RV,Mortier F,Bernheim J,Deliens L

    更新日期:2004-06-01 00:00:00

  • Mapping primary health care renewal in South America.

    abstract:BACKGROUND:Primary health care (PHC) renewal processes are currently ongoing in South America (SA), but their characteristics have not been systematically described. OBJECTIVE:The study aimed to describe and contrast the PHC approaches being implemented in SA to provide knowledge of current conceptions, models and cha...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmw013

    authors: Acosta Ramírez N,Giovanella L,Vega Romero R,Tejerina Silva H,de Almeida PF,Ríos G,Goede H,Oliveira S

    更新日期:2016-06-01 00:00:00

  • Diverse voices, simple desires: a conceptual design for primary care to respond to depression and related disorders.

    abstract:BACKGROUND:The World Health Organization and the World Organization of Family Doctors have called for 'doable' and 'limited' tasks to integrate mental health into primary care. Little information is provided about tasks GPs can undertake outside of guidelines that suggest to prescribe medication and refer to specialist...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmq016

    authors: Palmer V,Gunn J,Kokanovic R,Griffiths F,Shrimpton B,Hurworth R,Herrman H,Johnson C,Hegarty K,Blashki G,Butler E,Johnston-Ata'ata K,Dowrick C

    更新日期:2010-08-01 00:00:00

  • Family practitioners' attitudes and knowledge about irritable bowel syndrome: effect of a trial of physician education.

    abstract:BACKGROUND:Primary physicians care for most patients with irritable bowel syndrome (IBS), but data on their attitudes and knowledge about the disorder are limited to research in the UK. OBJECTIVE:The purpose of the present study was to assess US family practitioners' attitudes and knowledge about IBS and determine the...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmg608

    authors: Longstreth GF,Burchette RJ

    更新日期:2003-12-01 00:00:00

  • Meeting patient expectations of care: the major determinant of satisfaction with out-of-hours primary medical care?

    abstract:BACKGROUND:Client or consumer expectation is considered to influence their satisfaction with the service provided, but its importance has not been quantified in health care. OBJECTIVE:The aim of this study was to determine the effect of "patient expectations of care" on satisfaction with care provided by out-of-hours ...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/19.4.333

    authors: McKinley RK,Stevenson K,Adams S,Manku-Scott TK

    更新日期:2002-08-01 00:00:00

  • Pregnant women's ailments and psychosocial conditions.

    abstract::Pregnant women's ailments may cause anxiety and reduce the quality of life. Sixty-five pregnant women were followed prospectively in antenatal care in general practice, and spontaneously reported ailments not associated with serious pregnancy complications were registered prospectively. The vast majority of pregnant w...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/9.3.270

    authors: Førde R

    更新日期:1992-09-01 00:00:00

  • U-shaped association between mortality and blood pressure in a thirteen-year prospective study.

    abstract::The present study was performed to investigate the predictive value of casual blood pressure recordings for mortality in a geographically defined population (n = 1917), for which the primary health care services are responsible. Isotonic regression of blood pressure on age was used to define groups with low, medium an...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/3.1.3

    authors: Lindholm L,Lanke J,Bengtsson B

    更新日期:1986-03-01 00:00:00

  • The influence of a desk-top analyser on the number of laboratory tests used in daily general practice. A randomized controlled trial.

    abstract::This study evaluated the influence of a desk-top analyser, used in general practice, on the mean number of blood tests per contact, prescribed or analysed by general practitioners. A randomized controlled trial was used. The mean number of blood tests per contact requested by two groups of GPs, before and after the in...

    journal_title:Family practice

    pub_type: 临床试验,杂志文章,随机对照试验

    doi:10.1093/fampra/10.2.118

    authors: Gilio C,Buntinx F,De Kezel O,Scheys I

    更新日期:1993-06-01 00:00:00

  • Variation in general practitioners' depression care following certification of sickness absence: a registry-based cohort study.

    abstract:BACKGROUND:Depression is more prevalent among women and people with low socio-economic status. Uncertainties exist about how general practitioner (GP) depression care varies with patients' social position. OBJECTIVE:To investigate associations between patients' gender and educational status combined and GP depression ...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/cmaa120

    authors: Riiser S,Haukenes I,Baste V,Smith-Sivertsen T,Hetlevik Ø,Ruths S

    更新日期:2020-11-05 00:00:00

  • Shared care in gastroenterology: GPs' views of open access to out-patient follow-up for patients with inflammatory bowel disease.

    abstract:OBJECTIVE:The aim of this study was to ascertain GPs' views about open access to out-patient follow-up for patients with inflammatory bowel disease (IBD). METHODS:Semi-structured interviews and a postal survey were carried out in general practices in West Glamorgan UK, each with at least one IBD patient taking part in...

    journal_title:Family practice

    pub_type: 杂志文章

    doi:10.1093/fampra/19.1.53

    authors: Cheung WY,Dove J,Lervy B,Russell IT,Williams JG

    更新日期:2002-02-01 00:00:00