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Significance of automation in standardization of qualitative urinalysis

Introduction: With the rapid development of technology, qualitative urinalysis is nowadays in all segments fully automated, enabling standardization of the entire analytical procedure. The aim of our study was to evaluate analytical characteristics of the Siemens Atellica UAS 800 analyzer by comparing the results with Roche Cobas u701 analyzer and the reference method microscopic urine sediment analysis with supravital staining.Materials and methods: Comparison of two analyzers was performed on 155 urine samples using Passing Bablok regression and Bland Altman analysis for erythrocytes and leukocytes. The same statistical analysis was used to compare Atellica and microscope on 79 samples. The reference method microscopic urine sediment analysis is accredited ac-cording to ISO15189 and participates in the external quality control Labquality.Results: Passing Bablok analysis between Atellica and Roche yielded regression equations y = - 0.11 (- 0.21 to - 0.04) + 1.27 (1.10 to 1.51) x for erythrocytes and y = -0.46 (- 0.59 to - 0.33) + 1.22 (1.14 to 1.31) x for leukocytes. Comparing Atellica and microscopic analysis equations y = 0.39 (- 0.07 to 0.62) + 0.67 (0.42 to 1.18) x for erythrocytes and y = 0.48 (0.10 to 0.72) + 0.43 (0.34 to 0.53) x for leukocytes were obtained. Bland Altman analysis showed no statistically significant difference between Roche and Atellica for erythrocytes and leukocytes, while comparing Atellica and microscope there was no statistically significant difference for erythrocytes but it showed bias of -43.9% for leukocytes.Conclusion: Atellica showed excellent analytical characteristics with the ability to analyze up to 240 samples per hour, which significantly reduces Turn-around Time. Comparison of Roche and Atellica showed good correlation of results for erythrocytes and leukocytes. Although there is a statistically significant difference in the values of leukocytes, the results indicate a good correlation between automated analysis on Atellica and microscopic analysis due to the possibility of manually correcting the obtained results by trained laboratory personnel. However, the use of the reference method microscopic urine sediment analysis should not be neglected, particularly in highly blurred samples, urine samples containing dysmorphic erythrocytes and in determining the type of crystals in sediment which can’t be reliably analyzed by the analyzer.

Siemens Atellica UAS 800, analytical characteristics

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