Study designs of evaluations included in the review
Diagnostic accuracy studies in which both the screening test and the urine culture were performed on all participants, and the results of the screening test were not included in the definition of UTI, were eligible.
Specific interventions included in the review
Studies that used one or more of the following tests were eligible for inclusion: urine dipstick for leucocyte esterase and/or nitrite; microscopic analysis of centrifuged urine sample for white blood cells (WBC), reported as the number of WBC per high-powered field (WBC/hpf); microscopic analysis of uncentrifuged urine sample for WBC, reported as the number of WBC/mm3; Gram stain of uncentrifuged urine; or enhanced urinalysis (cell count and Gram stain on uncentrifuged urine).
Reference standard test against which the new test was compared
The reference test was quantitative or semiquantitative urine culture.
Participants included in the review
Studies of children aged 12 years or less were eligible for inclusion. Studies of adults and children were also eligible if the results for children could be separated. The people in the included studies were aged from 0 to 21 years. Methods for obtaining urine specimens included clean catch, urine bag, suprapubic aspirate and catheter. The settings included a laboratory, referral clinic, home, out-patient department, in-patient ward, paediatric clinic, and emergency and acute care clinics.
Outcomes assessed in the review
The studies had to report sufficient data to construct a 2x2 table of test performance, to give true-positive rates and false-positive rates (TPR and FPR, respectively).
How were decisions on the relevance of primary studies made?
The titles and abstracts were reviewed for possible relevance by two authors and any discrepancies were resolved by discussion and consensus. Articles deemed relevant were retrieved and reviewed.