{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T14:18:04Z","timestamp":1770905884540,"version":"3.50.1"},"reference-count":35,"publisher":"Wiley","issue":"2","license":[{"start":{"date-parts":[[2025,3,27]],"date-time":"2025-03-27T00:00:00Z","timestamp":1743033600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100005039","name":"Leids Universitair Medisch Centrum","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100005039","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Clinical Endocrinology"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Objective<\/jats:title><jats:p>Detecting hypotonic urine (specific gravity &lt;\u20091005\u2009g\/L) is crucial for the early identification of arginine vasopressin deficiency (AVP\u2010deficiency), a common complication after pituitary surgery. This study aimed to evaluate the agreement between urine specific gravity measurements taken by patients using urine test strips and those taken by nurses using a refractometer, to assess the reliability of patient\u2010conducted measurements for diagnosing this condition.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>A prospective cohort study was conducted in a neurosurgical ward.<\/jats:p><\/jats:sec><jats:sec><jats:title>Patients<\/jats:title><jats:p>The study included 110 participants who collectively provided 609 specific gravity measurements.<\/jats:p><\/jats:sec><jats:sec><jats:title>Measurements<\/jats:title><jats:p>Specific gravity measurements were taken using Combur\u201010 urine test strips by patients and using an ATAGO MASTER\u2010SUR\/N\u03b1 refractometer by nurses. Agreement was analysed using Weighted Kappa and intraclass correlation coefficient (ICC).<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Moderate agreement was found between patient\u2010conducted measurements and those from the refractometer (Kappa\u2009=\u20090.47, ICC\u2009=\u20090.69). Substantial to good agreement was observed between patient and nurse measurements using urine test strips (Kappa\u2009=\u20090.82, ICC\u2009=\u20090.89). A threshold of 1.015\u2009g\/L in test strip measurements ensured no cases of hypotonic urine were missed, reducing the need for nurse\u2010led testing by 50%. Patient satisfaction was high (mean 7.8), while nurse satisfaction was lower (mean 6.4).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Although patients are less accurate than nurses in measuring specific gravity, they can reliably screen for hypotonic urine in AVP\u2010deficiency diagnostics using urine test strips. A higher cut\u2010off point improves diagnostic accuracy, enhances patient participation and reduces the screening workload for nurses.<\/jats:p><\/jats:sec>","DOI":"10.1111\/cen.15241","type":"journal-article","created":{"date-parts":[[2025,3,30]],"date-time":"2025-03-30T03:20:28Z","timestamp":1743304828000},"page":"201-208","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Patient Participation in Urine Specific Gravity Screening for Arginine Vasopressin Deficiency in an Inpatient Neurosurgical Clinic"],"prefix":"10.1111","volume":"103","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1241-5380","authenticated-orcid":false,"given":"Jeanne\u2010Marie","family":"Nollen","sequence":"first","affiliation":[{"name":"Department of Neurosurgery Leiden University Medical Centre Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Anja H.","family":"Brunsveld\u2010Reinders","sequence":"additional","affiliation":[{"name":"Department of Quality and Patient Safety Leiden University Medical Centre Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nienke R.","family":"Biermasz","sequence":"additional","affiliation":[{"name":"Department of Endocrinology Leiden University Medical Centre Leiden the Netherlands"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marco J. 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