{"id":7957,"date":"2020-06-26T07:11:07","date_gmt":"2020-06-26T11:11:07","guid":{"rendered":"https:\/\/www.med.unc.edu\/urology\/?p=7957"},"modified":"2020-06-29T08:21:18","modified_gmt":"2020-06-29T12:21:18","slug":"new-2020-aua-hematuria-guidelines","status":"publish","type":"post","link":"https:\/\/www.med.unc.edu\/urology\/new-2020-aua-hematuria-guidelines\/","title":{"rendered":"New 2020 AUA Hematuria Guidelines"},"content":{"rendered":"

Dr. Matthew Nielsen<\/a>, Professor and Interim Chair of the Department, was a panelist and contributing author to the American Urological Association\u2019s new 2020 Guideline<\/a> for the evaluation of hematuria, released this week. The guideline will be presented by panel co-Chairs at the AUA Live Virtual Experience at 3:45pm on Saturday, June 27.<\/p>\n

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Hematuria is a common finding in clinical practice, with over 2 million American patients referred each year for evaluation, representing one of the most common diagnoses seen by urologists. The AUA panel aimed to develop and disseminate clear guideline recommendations for the evaluation of hematuria. This work sought to mitigate potentially avoidable risks and costs associated with the over-evaluation of patients at low risk for malignancy, while at the same time addressing the delays in diagnosis of important urologic conditions caused by widespread under-evaluation and variations in care. The new 2020 AUA Guideline provides an individualized, risk-stratified approach to hematuria evaluation based on the patient\u2019s risk of harboring a urinary tract cancer.<\/p>\n

\"2020<\/a><\/p>\n

Nielsen\u2019s work in this area started with a collaboration with the American College of Physicians\u2019 High Value Care Task Force<\/a>, published in 2016. This effort highlighted unexplained variation in care and raised questions related to potentially avoidable costs and harms from existing recommendations at that time, which recommended uniform evaluation with CT for all adults with hematuria. Last summer, a team of investigators from UNC published a simulation modeling study in JAMA Internal Medicine<\/a> examining tradeoffs of harm, benefit and cost associated with various strategies for hematuria evaluation, finding substantial potentially avoidable costs and harms from radiation exposure with a uniformly intensive approach.<\/p>\n