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Intended for Healthcare Professionals
British Journal of General Practice

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Astonishing results

Vincent Forte
British Journal of General Practice 2022; 72 (717): 157-158. DOI: https://doi.org/10.3399/bjgp22X718913
Vincent Forte
Forensic Physician, and Medical Author, retired, Forte Medical Ltd. Email:
Roles: GP
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Peezy was developed in response to patient feedback to address the hygiene and dignity issues complained of by patients. Evidence of reduced contamination of urine samples was found later.

Our UK and US customers have found reduced contamination, and savings in reduced retesting, overall expenditure, and antibiotic prescribing due to improved accuracy of diagnosis. Device failure is almost unknown. A recent anecdotal report from a US distributor states: ‘Some lab employees and the supervisor stated they had previously taken Peezy home for personal use. The lab supervisor felt Peezy was “indestructible”, and she was unable to get it to fail.’

Had we experienced the massive 25% device failure rate quoted, we would never have launched the product. We provide training for staff issuing Peezy. In turn, first-time users are correctly instructed in its use. Other than device supply, we were excluded from any involvement in the study, so this was not possible.

We wrote to the principal author asking to clarify if Peezy patients were asked to ensure a full bladder before sampling but this specific question was not answered. We cannot verify that Peezy was used correctly. The authors admit that the Peezy failure rate may have affected the analysis. ‘About a quarter of Peezy UCDs [urinary collection devices] failed, and this may have impacted the intention-to-treat analysis.’1

As a small to medium-sized enterprise we are unable to fund large clinical trials and rely on smaller independent studies. However, a reduction in contamination rates has been widely reported.2–7

Llor comments: ‘We certainly do not know how patients collect the urine samples despite being instructed to perform midstream urine sample collection.’8 Peezy standardises urine sampling. The National Institute for Health and Care Excellence says of Peezy: ‘The device is the only urine collection method that meets Public Health England’s UK Standards for Microbiology Investigations: Investigation of urine.’9

The astonishing failure rate is unprecedented, and points to inadequate instruction. The absence of sample contamination reduction contradicts the evidence given to us. We do not accept the results of this study, which is at odds with the clear satisfaction of our customers and their end users.

Notes

Competing interests

Vincent Forte is inventor of the Peezy and a Founder Director of Forte Medical Ltd.

  • © British Journal of General Practice 2022

REFERENCES

  1. 1.↵
    1. Hayward G,
    2. Mort S,
    3. Yu L-M,
    4. et al.
    (2022) Urine collection devices to reduce contamination in urine samples for diagnosis of uncomplicated UTI: a single-blind randomised controlled trial in primary care. Br J Gen Pract, DOI: https://doi.org/10.3399/BJGP.2021.0359.
  2. 2.↵
    1. Lewis T
    (2019) Use of Peezy device to try to improve quality of urine culture. https://girftpathology.blogspot.com/2019/03/use-of-peezy-device-to-try-to-improve.html (accessed 10 Mar 2022).
  3. 3.
    1. Bone S
    (2019) Midwifery BACK-TO-BASICS: auditing urinalysis in practice. https://www.all4maternity.com/midwifery-back-to-basics-auditing-urinalysis-in-practice (accessed 10 Mar 2022).
  4. 4.
    1. Southworth E,
    2. Hochstedler B,
    3. Price TK,
    4. et al.
    (2019) A cross-sectional pilot cohort study comparing standard urine collection to the Peezy Midstream device for research studies involving women. Female Pelvic Med Reconstr Surg 25, 2, e28–e33.
    OpenUrlCrossRef
  5. 5.
    1. Barts NHS Hospital London
    (2017) A comparative historic quality improvement audit of specimens collected in urology clinic. Unpublished data. Available on request.
  6. 6.
    1. Jie M,
    2. Adamczyk M,
    3. Morton K
    (2018) Midstream urine in obstetrics: improving diagnostic accuracy Royal Surrey County Hospital, Guildford. Poster presentation 0212https://obgyn.onlinelibrary.wiley.com/doi/10.1111/1471-0528.15493 (accessed 10 Mar 2022).
  7. 7.↵
    1. GP Liaison Services
    Case 4: UTI pathway improvement. https://www.gp-liaison.com/case-studies (accessed 10 Mar 2022).
  8. 8.↵
    1. Llor C
    (2022) Mid-stream vs. first-void urine sample. [Letter]. Br J Gen Pract, https://bjgp.org/content/early/2022/01/24/BJGP.2021.0359/tab-e-letters (accessed 10 Mar 2022).
  9. 9.↵
    1. National Institute for Health and Care Excellence
    (2019) Peezy Midstream for urine collection MedTech Innovation Briefing MIB183, https://www.nice.org.uk/advice/mib183/chapter/The-technology (accessed 10 Mar 2022).
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British Journal of General Practice: 72 (717)
British Journal of General Practice
Vol. 72, Issue 717
April 2022
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Astonishing results
Vincent Forte
British Journal of General Practice 2022; 72 (717): 157-158. DOI: 10.3399/bjgp22X718913

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Astonishing results
Vincent Forte
British Journal of General Practice 2022; 72 (717): 157-158. DOI: 10.3399/bjgp22X718913
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