Verification of the Reliability of an Automated Urine Test Strip Colorimetric Program Using Colorimetric Analysis: Survey Study

Abstract BackgroundOne method for noninvasive and simple urinary microalbumin testing is urine test strips. However, when visually assessing urine test strips, accurate assessment may be difficult due to environmental influences—such as lighting color and intensity—and the phy...

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Main Authors: Keigo Inagaki, Daisuke Tsuriya, Takuya Hashimoto, Katsumasa Nakamura
Format: Article
Language:English
Published: JMIR Publications 2025-01-01
Series:JMIR Formative Research
Online Access:https://formative.jmir.org/2025/1/e62772
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author Keigo Inagaki
Daisuke Tsuriya
Takuya Hashimoto
Katsumasa Nakamura
author_facet Keigo Inagaki
Daisuke Tsuriya
Takuya Hashimoto
Katsumasa Nakamura
author_sort Keigo Inagaki
collection DOAJ
description Abstract BackgroundOne method for noninvasive and simple urinary microalbumin testing is urine test strips. However, when visually assessing urine test strips, accurate assessment may be difficult due to environmental influences—such as lighting color and intensity—and the physical and psychological influences of the assessor. These complicate the formation of an objective assessment. ObjectivesThis study developed an “automated urine test strip colorimetric program” (hereinafter referred to as “this program”) to objectively assess urine test strips. Using this program may allow urine tests to be conducted at home. In this study, urine samples from hospitalized or outpatient patients were randomly obtained, and the reliability of this program was verified by comparing the agreement rate between this program and an automatic urine analyzer (US-3500 [Eiken Chemical Co, Ltd] and LABOSPECT 006 [Hitachi High-Tech Co, Ltd]). Furthermore, the sensitivity and specificity of the urine albumin test were investigated, and its applicability to screening for microalbuminuria was verified. MethodsA urine test strip was placed in a photography box with constant light intensity and color temperature conditions. The image taken with a smartphone camera on top of the photography box was judged by this program. This program used Accelerated KAZE to perform image-matching processing to reduce the effect of misalignment during photography. It also calculated and judged the item with the smallest color difference between the color chart and the urine test strip using the CIEDE2000 color difference formula. The agreement rate of the results of this program was investigated using the results of an automatic urine analyzer as the gold standard. ResultsCompared with the judgments of an automatic urine analyzer, the average agreement rate for 12 items (protein, glucose, urobilinogen, bilirubin, ketone bodies, specific gravity, occult blood, pH, white blood cells, nitrite, creatinine, and albumin) was 78.6%. Furthermore, the average agreement rate of the 12 items within ±1 rank was 95.4%. The results showed a sensitivity of 100% and a specificity of 58.6% in determining albumin in urine, which is important for determining the stage of diabetic nephropathy. Finally, the area under the curve (0.907) derived from the receiver operating characteristic curve was satisfactory. ConclusionsThe program developed by the authors can determine urine test strips without requiring calibration in a certain shooting environment. If this program can be used at home to perform urinary microalbumin tests, the early detection and treatment of diabetic nephropathy may prevent the condition from becoming severe.
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spelling doaj-art-e5c0a2a2a1e54f48b1355335e5d57e032025-01-21T21:01:05ZengJMIR PublicationsJMIR Formative Research2561-326X2025-01-019e62772e6277210.2196/62772Verification of the Reliability of an Automated Urine Test Strip Colorimetric Program Using Colorimetric Analysis: Survey StudyKeigo Inagakihttp://orcid.org/0000-0002-4479-1241Daisuke Tsuriyahttp://orcid.org/0009-0001-7891-5046Takuya Hashimotohttp://orcid.org/0000-0002-6761-0343Katsumasa Nakamurahttp://orcid.org/0000-0003-2090-881X Abstract BackgroundOne method for noninvasive and simple urinary microalbumin testing is urine test strips. However, when visually assessing urine test strips, accurate assessment may be difficult due to environmental influences—such as lighting color and intensity—and the physical and psychological influences of the assessor. These complicate the formation of an objective assessment. ObjectivesThis study developed an “automated urine test strip colorimetric program” (hereinafter referred to as “this program”) to objectively assess urine test strips. Using this program may allow urine tests to be conducted at home. In this study, urine samples from hospitalized or outpatient patients were randomly obtained, and the reliability of this program was verified by comparing the agreement rate between this program and an automatic urine analyzer (US-3500 [Eiken Chemical Co, Ltd] and LABOSPECT 006 [Hitachi High-Tech Co, Ltd]). Furthermore, the sensitivity and specificity of the urine albumin test were investigated, and its applicability to screening for microalbuminuria was verified. MethodsA urine test strip was placed in a photography box with constant light intensity and color temperature conditions. The image taken with a smartphone camera on top of the photography box was judged by this program. This program used Accelerated KAZE to perform image-matching processing to reduce the effect of misalignment during photography. It also calculated and judged the item with the smallest color difference between the color chart and the urine test strip using the CIEDE2000 color difference formula. The agreement rate of the results of this program was investigated using the results of an automatic urine analyzer as the gold standard. ResultsCompared with the judgments of an automatic urine analyzer, the average agreement rate for 12 items (protein, glucose, urobilinogen, bilirubin, ketone bodies, specific gravity, occult blood, pH, white blood cells, nitrite, creatinine, and albumin) was 78.6%. Furthermore, the average agreement rate of the 12 items within ±1 rank was 95.4%. The results showed a sensitivity of 100% and a specificity of 58.6% in determining albumin in urine, which is important for determining the stage of diabetic nephropathy. Finally, the area under the curve (0.907) derived from the receiver operating characteristic curve was satisfactory. ConclusionsThe program developed by the authors can determine urine test strips without requiring calibration in a certain shooting environment. If this program can be used at home to perform urinary microalbumin tests, the early detection and treatment of diabetic nephropathy may prevent the condition from becoming severe.https://formative.jmir.org/2025/1/e62772
spellingShingle Keigo Inagaki
Daisuke Tsuriya
Takuya Hashimoto
Katsumasa Nakamura
Verification of the Reliability of an Automated Urine Test Strip Colorimetric Program Using Colorimetric Analysis: Survey Study
JMIR Formative Research
title Verification of the Reliability of an Automated Urine Test Strip Colorimetric Program Using Colorimetric Analysis: Survey Study
title_full Verification of the Reliability of an Automated Urine Test Strip Colorimetric Program Using Colorimetric Analysis: Survey Study
title_fullStr Verification of the Reliability of an Automated Urine Test Strip Colorimetric Program Using Colorimetric Analysis: Survey Study
title_full_unstemmed Verification of the Reliability of an Automated Urine Test Strip Colorimetric Program Using Colorimetric Analysis: Survey Study
title_short Verification of the Reliability of an Automated Urine Test Strip Colorimetric Program Using Colorimetric Analysis: Survey Study
title_sort verification of the reliability of an automated urine test strip colorimetric program using colorimetric analysis survey study
url https://formative.jmir.org/2025/1/e62772
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AT takuyahashimoto verificationofthereliabilityofanautomatedurineteststripcolorimetricprogramusingcolorimetricanalysissurveystudy
AT katsumasanakamura verificationofthereliabilityofanautomatedurineteststripcolorimetricprogramusingcolorimetricanalysissurveystudy