The Italian External Quality Assessment (EQA) program on urinary sediment: Results of the period 2012-2015

Sandra Secchiero, Giovanni B. Fogazzi, Fabio Manoni, Mariagrazia Epifani, Giuseppe Garigali, Mario Plebani

Research output: Contribution to journalArticle

Abstract

Background: Manual microscopy still represents the gold standard for urinary sediment (US) examination. We report the results obtained in the period 2012-2015 by the EQA Italian program on US, which today involves about 260 laboratories. Methods: The program includes four surveys per year. In two surveys, participants are asked to supply identification and clinical association of US particles. In two other surveys, they are asked to supply the diagnosis of clinical cases, presented with images, some key laboratory findings and a short clinical history. Sixty-six images of US particles (21 cells, 2 lipids, 21 casts, 10 crystals, 3 microorganisms, 15 contaminants) and seven clinical cases were presented. Results: The correct identification rate for each category of particles, in decreasing order, was: micro-organisms (mean±SD: 92.4%±4.5%), lipids (92.0%±1.8%), casts (82.8%±8.8%), crystals (79.4%±29.8%), cells (77.3%±13.5%), and contaminants (70.9%±22.2%). For 13 particles, a correct clinical association was indicated by 91.5%±11.7% of participants, while it was 52.7% for particles associated with urinary tract infection. For clinical cases, due to a high rate of particles misidentification, only 44.3%±10.1% of participants achieved access to clinical diagnosis, which was then correctly indicated by 92.5%±5.3% of them. Conclusions: The results of the EQA program confirm that, while some US particles are well known in terms of identification, clinical association and clinical meaning, others particles still are not, and this represents an important reason to encourage EQA programs on US.

Original languageEnglish
Pages (from-to)S1495-S1502
JournalClinical Chemistry and Laboratory Medicine
Volume53
DOIs
Publication statusPublished - Nov 1 2015

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Sediments
Lipids
Urinary Tract Infections
Microscopy
Impurities
Crystals
Microorganisms
Surveys and Questionnaires
Microscopic examination

Keywords

  • external quality assessment programs
  • urinalysis
  • urinary sediment

ASJC Scopus subject areas

  • Clinical Biochemistry
  • Biochemistry, medical

Cite this

The Italian External Quality Assessment (EQA) program on urinary sediment : Results of the period 2012-2015. / Secchiero, Sandra; Fogazzi, Giovanni B.; Manoni, Fabio; Epifani, Mariagrazia; Garigali, Giuseppe; Plebani, Mario.

In: Clinical Chemistry and Laboratory Medicine, Vol. 53, 01.11.2015, p. S1495-S1502.

Research output: Contribution to journalArticle

Secchiero, Sandra ; Fogazzi, Giovanni B. ; Manoni, Fabio ; Epifani, Mariagrazia ; Garigali, Giuseppe ; Plebani, Mario. / The Italian External Quality Assessment (EQA) program on urinary sediment : Results of the period 2012-2015. In: Clinical Chemistry and Laboratory Medicine. 2015 ; Vol. 53. pp. S1495-S1502.
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AB - Background: Manual microscopy still represents the gold standard for urinary sediment (US) examination. We report the results obtained in the period 2012-2015 by the EQA Italian program on US, which today involves about 260 laboratories. Methods: The program includes four surveys per year. In two surveys, participants are asked to supply identification and clinical association of US particles. In two other surveys, they are asked to supply the diagnosis of clinical cases, presented with images, some key laboratory findings and a short clinical history. Sixty-six images of US particles (21 cells, 2 lipids, 21 casts, 10 crystals, 3 microorganisms, 15 contaminants) and seven clinical cases were presented. Results: The correct identification rate for each category of particles, in decreasing order, was: micro-organisms (mean±SD: 92.4%±4.5%), lipids (92.0%±1.8%), casts (82.8%±8.8%), crystals (79.4%±29.8%), cells (77.3%±13.5%), and contaminants (70.9%±22.2%). For 13 particles, a correct clinical association was indicated by 91.5%±11.7% of participants, while it was 52.7% for particles associated with urinary tract infection. For clinical cases, due to a high rate of particles misidentification, only 44.3%±10.1% of participants achieved access to clinical diagnosis, which was then correctly indicated by 92.5%±5.3% of them. Conclusions: The results of the EQA program confirm that, while some US particles are well known in terms of identification, clinical association and clinical meaning, others particles still are not, and this represents an important reason to encourage EQA programs on US.

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