(Original Article) A Comparative Study of Urine Sediment Analysis between Manual Operators and the iQ200 Analyzer

Sasikrit Theppabutr

Authors

Sasikrit Theppabutr Department of Medical Technology and Clinical Pathology, Maharat Nakhon Ratchasima Hospital, Nakhon Ratchasima Province, Thailand

Keywords:

Agreement, Automated urine sediment analyzer iQ200, Urine sediment analysis, Weighted Kappa

Abstract

Urine sediment analysis is an essential diagnostic tool for evaluating urinary tract disorders. Automated urine microscopy analyzers, such as the iQ200 analyzer, have been developed to improve laboratory efficiency and reduce operator-dependent variability. This study aimed to compare urine sediment analysis results obtained from the iQ200 automated urine microscopy analyzer with manual microscopy performed by experienced laboratory personnel, focusing on red blood cells (RBCs), white blood cells (WBCs), squamous epithelial cells, and casts. A comparative analytical study was conducted using 200 urine samples collected from patients at the Clinical Microscopy Division, Department of Medical Technology and Clinical Pathology, Maharat Nakhon Ratchasima Hospital. Manual microscopy was performed according to standard procedures, and automated analysis was conducted using the iQ200 analyzer. Agreement between the two methods was assessed using Weighted Kappa (k_w), with statistical significance set at p < 0.05. The iQ200 analyzer demonstrated almost perfect agreement for RBCs (Weighted Kappa = 0.929) and WBCs (Weighted Kappa = 0.875), substantial agreement for squamous epithelial cells (Weighted Kappa = 0.772), and moderate agreement for casts (Weighted Kappa = 0.543). All results were statistically significant agreement (p < 0.05). These findings confirm that the iQ200 automated analyzer is reliable for routine urine sediment analysis, particularly for RBC and WBC detection, while further improvements are recommended to enhance the accuracy of cast detection in clinical practice.

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