Cross-sectional diagnostic accuracy study of self-testing for proteinuria during hypertensive pregnancies: The UDIP study.
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Jakubowski, B., Stevens, R., Wilson, H., Lavallee, L., Brittain, L., Crawford, C., Hodgkinson, J., et al. (2022). Cross-sectional diagnostic accuracy study of self-testing for proteinuria during hypertensive pregnancies: The UDIP study.. BJOG https://doi.org/10.1111/1471-0528.17180
Funder: National Institute for Health Research (NIHR) Collaboration for Leadership in Applied Health Research (CLAHRC)
Funder: National Institute for Health Research Oxford Biomedical Research Centre
Funder: Primary Care Research Trust
OBJECTIVE: To determine the accuracy of self-testing for proteinuria during pregnancy. DESIGN: Diagnostic accuracy study. SETTING: Antenatal clinics, maternity assessment units, and inpatient wards at three hospital sites. POPULATION OR SAMPLE: 345 pregnant women. METHODS: Pregnant women self-tested in-clinic for urinary protein using visually read dipsticks with samples then sent for laboratory estimation of the spot protein-creatinine ratio (PCR) (primary reference test). Secondary index tests included testing by antenatal healthcare professionals and an automated colorimetric reader. MAIN OUTCOME MEASURES: Sensitivity, specificity, negative predictive value, positive predictive value and likelihood ratios were calculated for self-testing (primary index test) along with healthcare professional and colorimetric testing compared to the primary reference (PCR). RESULTS: 335/345 (97%) had sufficient data to be included in the analysis. Self-testing had a sensitivity of 0.71 [95% CI 0.62 - 0.79] and a specificity of 0.89 [95% CI 0.84 - 0.92] compared to PCR. Sensitivity and specificity of testing by healthcare professionals and the colorimetric reader were similar: sensitivity 0.73 [95% CI 0.64 - 0.80] and 0.78 [95% CI 0.69 - 0.85] respectively; specificity 0.88 [95% CI 0.82 - 0.92] and 0.83 [95% CI 0.78 - 0.88] respectively. CONCLUSION: Pregnant women can visually read a dipstick for urinary protein with similar accuracy to antenatal healthcare professionals. Automated colorimetric testing was not significantly different, in contrast to some previous studies. Self-testing has the potential to form part of a self-monitoring regime in pregnancy.
RESEARCH ARTICLE, RESEARCH ARTICLES, diagnostic accuracy study, hypertension, pre‐eclampsia, pregnancy, proteinuria, self‐testing
National Institute for Health Research (RP‐PG‐0614‐20005)
National Institute for Health Research Professorship (NIHR‐RP‐R2‐12‐015)
External DOI: https://doi.org/10.1111/1471-0528.17180
This record's URL: https://www.repository.cam.ac.uk/handle/1810/337123