Objectives: Urinalysis is one of the most commonly performed tests in the clinical laboratory. However, manual microscopic sediment examination is labor-intensive, time-consuming, and lacks standardization in high-volume laboratories. In this study, the concordance of analyses between manual microscopic examination and Iris iQ® 200 automatic urine analyzers has been evaluated. Design and methods: 250 urine samples were analyzed by the Iris iQ® 200 and by manual microscopic examination. The degree of concordance (Kappa coefficient) and the rates within the same grading were evaluated. Results: In our study manual method and automated analyzer (Iris iQ® 200) show agreement for almost all parameters studied, but concordance for leukocyte and bacteria is very good. For erythrocyte it is moderate. For epithelial cells, cast and crystal concordance is good. Even for mucous and yeast, there is an agreement between the automated analyzer and manual method. Conclusion: We conclude that automated urine sediment analysis is sufficiently precise and improves the workflow in a routine laboratory significantly. However, to avoid any error or uncertainty, some images (particularly: dysmorphic cells, bacteria, yeasts, casts, and crystals) have to be analyzed by manual microscopic examination. Therefore, the software programs which are used in automatic urine sediment analyzers need further development to recognize urinary-shaped elements more accurately.
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