Is routine urine testing in outpatient clinics useful?

Patients, methods, and results For 25 weeks records were kept of all routine urine tests on new patients seen in adult clinics (other than antenatal) at this hospital. The tests were performed by nurses with dipsticks (BM-Test-5L; Boehringer, Mannheim); the urine sample had been collected by the patient at home or provided on arrival. The graded results for protein, blood, and glucose were recorded in the hospital notes before the patient was seen by a doctor. Hospital notes for patients with abnormal results were reviewed at least six months after the initial attendance and a judgment made as to whether the abnormality might have been expected from information already available at the first visit. For unexpected results evidence of an attempt to discover the cause was sought and the eventual diagnosis noted. Information on 2184 male and 3702 female patients aged 1-95 was recorded. They attended medical (1891 patients), gynaecological (1808), surgical (1240), urological (726), and geriatric (221) clinics. In 287 patients (4 9%) protein, glucose, or blood was detected to some degree (+, + +, or + + +). Patients who had abnormal results were older than those who had normal results (mean age 60-8 (SD 15-4) years v 49 5 (18-6) for male patients (t test, p<0-001) and 53 2 (18 8) v 43-6 (18-8) for female patients (p<0-001)). Overall, abnormal results were more common in male (7-8%; 171/2184) than female (3 1%; 116/3702) patients (X2=64-3, p<0-001), but no such difference was found in patients attending medical and surgical clinics, where the age distribution in the sexes was similar (x2=3 7, p>0 5). The prevalence of abnormal results differed strikingly between clinics (X2=297, p<O-OOl) largely because it was very low in gynaecological patients (0-6%; 11/1808). In 166 of the 287 patients with positive findings the result could have been expected from information already available when the patient was first seen. Among the 121 others further investigations had been carried out in only 60. In 30 patients (0 5% of all those tested) new diagnoses had been made (table).