Quality of case–control studies examining the effect of circumcision on urinary tract infection in male subjects
Reference | Definition of UTI | Determination of circumcision status | Exclusion criteria | Origin of controls | Adjustment for confounding variables | |||||
---|---|---|---|---|---|---|---|---|---|---|
Age | SES | Ethnicity | ||||||||
CSU, catheter specimen of urine; MSU, midstream urine; SES, socioeconomic status; SPA, suprapubic aspirate; UTI, urinary tract infection. | ||||||||||
Newman et al24 | Bag urine or clean catch ⩾107/l | Standard questionnaire | No fever >38°C or urine collected at presentation | Patients presenting to non-hospital outpatients with a fever | No | No | No | |||
CSU ⩾2×106/l | Uncertain circumcision status | |||||||||
SPA ⩾104/l | ||||||||||
Craig et al23 | CSU/SPA ⩾106/l | Direct questioning of parents or direct examination | Past history of UTI or urinary tract abnormality; neurological or skeletal abnormality predisposing to UTI | Patients presenting to hospital emergency department for any reason other than those diagnosed with UTI | Yes | No | No | |||
MSU ⩾108/l | ||||||||||
Rushton and Majd25 | MSU ⩾108/l | Cases: “prospectively” found but not specified | Prolonged neonatal hospital admission or uncertain circumcision status | Patients admitted with febrile upper respiratory tract infection. Matched for age, race, and SES | No | Yes | Yes | |||
CSU ⩾107/l | Controls: documentation in medical record but no further details given | |||||||||
Spach et al26 | MSU >106/l growth along with one or more symptoms | Examination | No clear exclusion criteria | Patients without bacteriuria presenting to outpatient clinic | Yes | No | Yes | |||
Crain and Gershel27 | Bag urine ⩾104/l | Documentation in medical records no further details given | Absence of fever | Patients presenting to hospital with fever and without a discharge diagnosis of UTI | No | No | No | |||
CSU ⩾104/l | ||||||||||
SPA ⩾102/l | ||||||||||
Kashani and Faraday28 | CSU/SPA ⩾108/l | Documentation in medical record | Urinary tract abnormality, inadequate documentation of specimen type or age <1 month | Patients presenting to outpatients clinics for unrelated reasons | No | No | Yes | |||
Herzog29 | CSU/SPA ⩾107/l | Documentation in medical record or direct contact with family if unclear in medical records | Anatomical abnormality, past history of UTI, myelodysplasia, uncertain circumcision status or race, and equivocal culture results | Patients who presented to emergency with a febrile illness and had a SPA or CSU which was negative | Yes | Yes | Yes |