Guidelines based on evidence or expert opinion, even when available, seem to be followed only occasionally. What do pediatricians do in practice with screening UAs?
Pediatricians’ screening urinalysis practices. J Pediatr 147:362-5, 2005 doi: 10.1016/j.peds.2005.05.009
This survey study examined the self-reported practices of general pediatricians in the US at a time when UA was recommended at 2 ages: start of school, ~5 years old, and sexually active adolescents. They asked when all asymptomatic children seen in the practice were screened at least once with the following choices:
- Infancy (<1 year of age)
- Early childhood (1 to 5 years of age)
- Late childhood (5 to 12 years of age)
- Adolescence (12 to 20 years of age)
Yes, they included the only definitely recommended age in two choices in their survey (why didn’t someone see this ahead of time?). The majority of responders (78%) screened at least once, with 58% screening more than one age group, leading to the following results:
- Infancy 9%
- Early childhood 60%
- Late childhood 55%
- Adolescence 58%
Pediatricians reported that they felt this screening benefitted the children and their overall health. Beyond that, the survey did not attempt to elucidate the rationale for practices identified. Were physicians unaware of changes in guidelines?
What is the downside of screening so many, so often? Next up we will look at the costs of this practice.