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    Study data may help risk stratify microhematuria Dx

    Higher levels of blood in first UA linked to kidney, bladder cancer risk


    The authors found that the rates of bladder and kidney cancer as well as urolithiasis depended on how thoroughly the patients were evaluated. In those who had a complete workup (cystoscopy and imaging), the rates of diagnosis were 4.7%, 3.1%, and 16.5%, respectively for bladder cancer, kidney cancer, and urolithiasis.

    Also see: Bladder Ca linked to risk of second primary cancer

    Higher levels of blood in the urine on the first urinalysis, especially >100 RBC/hpf, were linked to higher risk of these conditions. Also importantly, men and older patients were found to be at highest risk for malignant diagnoses.

    The authors say their findings shouldn’t change practice now. But the research is serving as proof of concept and pilot data for a combined quality improvement/research endeavor that’s been funded through the 2016 Clinical Care Innovation Pilot award from the American Association of Medical Colleges, Dr. Matulewicz said.

    The funding will support the development of a learning health system module for implementation into the electronic medical record at Northwestern.

    “This platform will collect granular data on our microhematuria patients’ risk factors, urinalysis details, and workup findings/outcomes,” Dr. Matulewicz said. “Further, our research demonstrated that very few—roughly 10%—of patients had a complete hematuria evaluation. This may be due to the complexity of care coordination associated with a complete evaluation, so in addition to collecting data prospectively, we plan to integrate a microhematuria ‘dashboard’ for internists. This will ensure that a patient’s complete evaluation is performed after they are seen in their primary care physicican’s office.”

    “We hope to use this information to develop a robust risk-stratification model and eventually a risk calculator to be used at the point of care to help urologists and their patients have a shared decision-making discussion about undergoing an evaluation,” Dr. Matulewicz added.

    More from Urology Times:

    Bladder Ca guide provides risk-stratified framework

    AUA 2016 Bladder Ca take-homes: Androgen receptor activation a potential therapeutic target

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    Randy Dotinga
    Randy Dotinga is a medical writer based in San Diego, Calif.


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