August 8th, 2019

Podcast 228: Hematuria — should the workup include imaging?

(2 votes, average: 4.00 out of 5)

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.


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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