Patient Participation in Urine Specific Gravity Screening for Arginine Vasopressin Deficiency in an Inpatient Neurosurgical Clinic
Authors' conclusion
Although patients are less accurate than nurses in measuring specific gravity, they can reliably screen for hypotonic urine in AVP-deficiency diagnostics using urine test strips. A higher cut-off point improves diagnostic accuracy, enhances patient participation and reduces the screening workload for nurses.
Study context
- Population
- Inpatients in a neurosurgical ward, screening for hypotonic urine (specific gravity < 1005 g/L) for AVP-deficiency after pituitary surgery609 measurements
- Participants
- 110 inpatients
- Exposure
- Patient-conducted urine test strip vs nurse-conducted refractometer specific gravity measurements
- Outcome
- Agreement between patient test strip and nurse refractometer urine specific gravity measurements (weighted kappa, ICC)
Methodological detailssingle neurosurgical ward
- Single neurosurgical ward
Main finding
As reported in the abstract
Agreement, patient test strip vs refractometer
Moderate agreement, weighted kappa
0.47
Intraclass correlation coefficient (ICC)
0.69
Observational data: associations, not effects.
Further findings
Agreement, patient vs nurse measurements using urine test strips
- Substantial to good agreement, kappa
- 0.82
- ICC
- 0.89
Test strip threshold of 1.015 g/L
- Reduction in need for nurse-led testing
- 50%
- No cases of hypotonic urine missed
Satisfaction
- Patient satisfaction, mean (high)
- 7.8
- Nurse satisfaction, mean (lower)
- 6.4
Original publication
Patient Participation in Urine Specific Gravity Screening for Arginine Vasopressin Deficiency in an Inpatient Neurosurgical Clinic. Clin Endocrinol (Oxf). Published 27 March 2025. doi:10.
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