We thank Dr Forte for his comments on our findings. Our randomised, controlled clinical trial reported on the use of two urine collection devices in women presenting to primary care with symptoms attributable to urinary tract infection (UTI). Frequency is a cardinal symptom of acute UTI. Requiring these women to have a full bladder before using such devices is not feasible, nor is it easy to objectively confirm.
Our participants were only eligible for inclusion if they felt able to produce a urine sample at the time of randomisation. As such, the use of urine collection devices in our pragmatic study is likely to be similar to how the devices might be used by women with UTI symptoms who consult in routine general practice. We made no claim that our findings apply to use in the populations that Dr Forte refers to, such as asymptomatic pregnant women and in preoperative assessment.