The Effects of Proficiency and Bias on Residents’ Interpretation of the Microscopic Urinalysis

Stephen D. Flach, Gay J. Canaris, Thomas G. Tape, Kathryn M. Huntley and Robert S. Wigton
Additional contact information
Stephen D. Flach: University of Iowa College of Medicine and Public Policy Center, Iowa City, Iowa
Gay J. Canaris: Section of General Internal Medicine, Department of Internal Medicine, University of Nebraska Medical Center College of Medicine, Omaha, Nebraska
Thomas G. Tape: Section of General Internal Medicine, Department of Internal Medicine, University of Nebraska Medical Center College of Medicine, Omaha, Nebraska
Kathryn M. Huntley: Skyline Hospital, White Salmon, Washington
Robert S. Wigton: Section of General Internal Medicine, Department of Internal Medicine, University of Nebraska Medical Center College of Medicine, Omaha, Nebraska

Medical Decision Making, 2002, vol. 22, issue 4, 318-325

Abstract: Objective . This study aims to determine whether residents are influenced by clinical information when interpreting microscopic urinalysis (UA) and estimating the probability of a urinary tract infection (UTI), and to determine the accuracy and reliability of UA readings. Design . Residents estimated the UA white blood cell count and the probability of a UTI in vignettes using a fractional factorial design, varying symptoms, gender, and the white blood cell count on preprepared urine slides. Results . Individual-level results indicated a clinical information bias and poor accuracy. Seventeen of 38 residents increased the white blood cell count in response to female gender; 14 increased the white blood cell count in response to UTI symptoms. Forty-nine percent of the readings were inaccurate; agreement ranged from 50% to 67% for white and red blood cells and bacteria. Conclusion . Many residents gave inaccurate UA readings, and many readings varied with clinical information. A significant portion of residents needs assistance in objectively and accurately interpreting the UA.

Keywords: microscopic urinalysis; residents; accuracy; clinical information bias; probability estimates; urinary tract infection (search for similar items in EconPapers)
Date: 2002
References: View complete reference list from CitEc
Citations:

Downloads: (external link)
https://journals.sagepub.com/doi/10.1177/0272989X0202200410 (text/html)

Related works:
This item may be available elsewhere in EconPapers: Search for items with the same title.

Export reference: BibTeX RIS (EndNote, ProCite, RefMan) HTML/Text

Persistent link: https://EconPapers.repec.org/RePEc:sae:medema:v:22:y:2002:i:4:p:318-325

DOI: 10.1177/0272989X0202200410

Access Statistics for this article

More articles in Medical Decision Making
Bibliographic data for series maintained by SAGE Publications ().