Coefficient-Based Models for Symptoms and Signs; Symptoms, Signs and Dipstick Results, Including Results Based on Multiple Imputation
| Index Tests | Symptom and Sign Model | Symptom, Sign, and Dipstick Model | ||
|---|---|---|---|---|
| Adjusted ORa (95% CI)b | MI Adjusted ORa (95% CI) | Adjusted ORa (95% CI)b | MI Adjusted ORa (95% CI) | |
| Pain/crying when passing urine | ||||
| No problem | 1 [reference] | 1 [reference] | 1 [reference] | 1 [reference] |
| Slight problem | 1.56 (0.68–3.61) | 1.73 (0.73–4.06) | 1.01 (0.37–2.80) | 1.16 (0.41–3.24) |
| Moderate problem | 4.58 (2.27–9.25) | 4.80 (2.30–10.04) | 2.68 (1.16–6.18) | 2.87 (1.21–6.82) |
| Severe problem | 14.32 (6.81–30.11) | 15.81 (7.37–33.89) | 9.64 (3.92–23.69) | 10.33 (4.11–25.96) |
| Smelly urine | ||||
| No problem | 1 [reference] | 1 [reference] | 1 [reference] | 1 [reference] |
| Slight problem | 4.08 (2.00–8.33) | 4.28 (2.02–9.05) | 2.97 (1.29–6.85) | 3.16 (1.32–7.59) |
| Moderate problem | 5.00 (2.64–9.48) | 5.14 (2.60–10.19) | 4.16 (2.02–8.57) | 4.34 (2.00–9.39) |
| Severe problem | 8.49 (3.74–19.26) | 8.76 (3.76–20.41) | 4.13 (1.51–11.31) | 4.44 (1.57–12.54) |
| Previous UTI | ||||
| No | 1 [reference] | 1 [reference] | 1 [reference] | 1 [reference] |
| Yes | 2.71 (1.39–5.27) | 2.66 (1.34–5.26) | 2.39 (1.12–5.11) | 2.36 (1.10–5.03) |
| Cough | ||||
| No problem | 1 [reference] | 1 [reference] | 1 [reference] | 1 [reference] |
| Slight problem | 1.28 (0.67–2.45) | 1.32 (0.68–2.55) | 1.27 (0.59–2.72) | 1.30 (0.60–2.81) |
| Moderate problem | 1.31 (0.69–2.48) | 1.38 (0.72–2.68) | 1.95 (0.95–4.00) | 2.04 (0.98–4.22) |
| Severe problem | 0.28 (0.08–0.93) | 0.29 (0.09–0.97) | 0.36 (0.09–1.48) | 0.36 (0.09–1.51) |
| Clinician global impression of illness severityc | ||||
| 0–1 | 1 [reference] | 1 [reference] | 1 [reference] | 1 [reference] |
| 2 | 1.97 (0.95–4.12) | 1.98 (0.93–4.19) | 2.14 (0.93–4.91) | 2.13 (0.92–4.97) |
| 3 | 2.66 (1.28–5.54) | 2.72 (1.28–5.81) | 2.65 (1.16–6.07) | 2.63 (1.13–6.14) |
| 4–5 | 3.57 (1.61–7.91) | 3.87 (1.72–8.73) | 2.96 (1.18–7.42) | 3.24 (1.28–8.24) |
| 6 or more | 6.84 (2.52–18.56) | 7.24 (2.59–20.25) | 5.80 (1.81–18.60) | 6.28 (1.92–20.61) |
| Abdominal examination: any tenderness | ||||
| No | 1 [reference] | 1 [reference] | 1 [reference] | 1 [reference] |
| Yes | 2.40 (1.03–5.61) | 2.24 (0.95–5.25) | 1.34 (0.40–4.45) | 1.18 (0.35–3.94) |
| Ear examination: any acute abnormality | ||||
| No | 1 [reference] | 1 [reference] | 1 [reference] | 1 [reference] |
| Yes | 0.30 (0.11–0.83) | 0.27 (0.10–0.74) | 0.46 (0.18–1.22) | 0.40 (0.15–1.09) |
| Dipstick: leukocytes | ||||
| Negative | … | … | 1 [reference] | 1 [reference] |
| Trace | … | … | 1.81 (0.68–4.81) | 1.78 (0.66–4.78) |
| 1+ | … | … | 0.70 (0.16–3.13) | 0.66 (0.14–3.12) |
| 2+ | … | … | 5.27 (2.52–11.04) | 5.19 (2.45–10.98) |
| 3+ | … | … | 10.45 (4.11–26.53) | 10.36 (3.94–27.26) |
| Dipstick: nitrites | ||||
| Negative | … | … | 1 [reference] | 1 [reference] |
| Positive | … | … | 5.25 (2.56–10.77) | 5.37 (2.58–11.19) |
| Dipstick: blood | ||||
| Negative | … | … | 1 [reference] | 1 [reference] |
| Non-heme | … | … | 0.88 (0.36–2.17) | 0.89 (0.35–2.21) |
| Heme trace | … | … | 4.16 (1.34–12.85) | 4.08 (1.28–13.05) |
| Heme 1+ | … | … | 2.65 (0.87–8.03) | 2.84 (0.92–8.79) |
| Heme 2+ or 3+ | … | … | 1.71 (0.65–4.51) | 1.74 (0.64–4.73) |
| AUROC curve (95% CI)d | 0.89 (0.84–0.94) | 0.90 (0.85–0.95) | 0.93 (0.89–0.96) | 0.93 (0.90–0.97) |
| Validated AUROC curvee | 0.87 | 0.88 | 0.90 | 0.90 |
| Calibration slopee | 0.89 | 0.87 | 0.83 | 0.83 |
AUROC = area under the receiver operating characteristic; MI = multiple imputation; OR = odds ratio; UTI = urinary tract infection.
↵a Calculated using shrunken estimates from the bootstrap internal validation calibration slope.
↵b Missing values coded to modal category.
↵c Graded on a scale from 1 to 10, where higher scores indicate greater severity.
↵d Calculated without internal validation.
↵e Calculated from the bootstrap internal validation.