August 8th, 2019

Podcast 228: Hematuria — should the workup include imaging?

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Matthew Nielsen and colleagues found almost 80 diagnostic algorithms for working up a finding of hematuria. From these, they chose five representative approaches, ranging from those based on the patients’ risk factors to more aggressive ones that stress CT imaging for all.

Using a 100,000-patient simulated cohort, Nielsen’s group found that more intensive imaging found more cancers than the other approaches. However, radiation-induced cancers from CT wiped out that advantage.

Join us as Dr. Nielsen walks through his findings and their clinical implications. The work appeared in JAMA Internal Medicine.

Links:

JAMA Internal Medicine article

NEJM Journal Watch General Medicine summary of ACP guidance on evaluating hematuria (from 2016)

American Urological Association guideline (from 2012)

 

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