Female Patient Self-diagnosis Compared With Emergency Physician Diagnosis of Urinary Tract Infection

Abstract

BackgroundUrinary tract infection (UTI) is a common emergency department (ED) complaint and self-diagnosis may be possible. ObjectiveThe objective was to compare female patient self-diagnosis compared with emergency physician (EP) diagnosis of UTI. MethodsThis was a prospective cohort study in a single urban ED. Women aged 18–64 years with a chief complaint of UTI, urinary frequency, or dysuria who presented to an urban academic ED were enrolled in a convenience sample fashion. Patients completed a written four-question survey by an ED greeter before triage. Charts of respondents were reviewed for demographic, laboratory, and EP diagnosis. ResultsFifty women were enrolled; 100% of patients who were approached participated in the study. Mean age was 33.7 years (standard deviation 13.8). Forty-three patients (86%) had a history of UTI. Forty-one patients (82%) thought they had a UTI on the index visit. Thirty patients (60%) preferred to buy over-the-counter antibiotics for their symptoms instead of seeing a doctor. Fifteen patients (30%) identified a specific antibiotic they would take. Of the 41 patients who thought they had a UTI, 25 (61%) were given that diagnosis. Of the 30 patients who would have preferred over-the-counter antibiotics, 20 (67%) were actually prescribed them. Agreement between EP and women's final impressions was low (κ = 0.11). ConclusionsThere was poor agreement between EP diagnosis and self-diagnosis of UTI. In our ED population, women should be encouraged to seek medical attention to confirm the diagnosis.