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dc.contributor.authorKhadhouri, S.
dc.contributor.authorGallagher, K. M.
dc.contributor.authorMacKenzie, K. R.
dc.contributor.authorShah, T. T.
dc.contributor.authorGao, C.
dc.contributor.authorMoore, S.
dc.contributor.authorZimmermann, E. F.
dc.contributor.authorEdison, E.
dc.contributor.authorJefferies, M.
dc.contributor.authorNambiar, A.
dc.contributor.authorAnbarasan, T.
dc.contributor.authorMannas, M. P.
dc.contributor.authorLee, T.
dc.contributor.authorMarra, G.
dc.contributor.authorGómez Rivas, J.
dc.contributor.authorMarcq, G.
dc.contributor.authorAssmus, M. A.
dc.contributor.authorUçar, T.
dc.contributor.authorClaps, F.
dc.contributor.authorBoltri, M.
dc.contributor.authorLa Montagna, G.
dc.contributor.authorBurnhope, T.
dc.contributor.authorNkwam, N.
dc.contributor.authorAustin, T.
dc.contributor.authorBoxall, N. E.
dc.contributor.authorDowney, A. P.
dc.contributor.authorSukhu, T. A.
dc.contributor.authorAntón-Juanilla, M.
dc.contributor.authorRai, S.
dc.contributor.authorChin, Y. F.
dc.contributor.authorMoore, M.
dc.contributor.authorDrake, T.
dc.contributor.authorGreen, J. S. A.
dc.contributor.authorGoulao, B.
dc.contributor.authorMacLennan, G.
dc.contributor.authorNielsen, M.
dc.contributor.authorMcGrath, J. S.
dc.contributor.authorKasivisvanathan, V.
dc.date.accessioned2022-12-08T14:38:12Z
dc.date.available2022-12-08T14:38:12Z
dc.date.issued2022-06-24
dc.identifier.citationEur Urol Focus. 2022 Jun 24:S2405-4569(22)00129-8. doi: 10.1016/j.euf.2022.06.001.
dc.identifier.pmid35760722
dc.identifier.doi10.1016/j.euf.2022.06.001
dc.identifier.urihttps://rde.dspace-express.com/handle/11287/622653
dc.description.abstractBACKGROUND: Patient factors associated with urinary tract cancer can be used to risk stratify patients referred with haematuria, prioritising those with a higher risk of cancer for prompt investigation. OBJECTIVE: To develop a prediction model for urinary tract cancer in patients referred with haematuria. DESIGN, SETTING, AND PARTICIPANTS: A prospective observational study was conducted in 10 282 patients from 110 hospitals across 26 countries, aged ≥16 yr and referred to secondary care with haematuria. Patients with a known or previous urological malignancy were excluded. OUTCOME MEASUREMENTS AND STATISTICAL ANALYSIS: The primary outcomes were the presence or absence of urinary tract cancer (bladder cancer, upper tract urothelial cancer [UTUC], and renal cancer). Mixed-effect multivariable logistic regression was performed with site and country as random effects and clinically important patient-level candidate predictors, chosen a priori, as fixed effects. Predictors were selected primarily using clinical reasoning, in addition to backward stepwise selection. Calibration and discrimination were calculated, and bootstrap validation was performed to calculate optimism. RESULTS AND LIMITATIONS: The unadjusted prevalence was 17.2% (n = 1763) for bladder cancer, 1.20% (n = 123) for UTUC, and 1.00% (n = 103) for renal cancer. The final model included predictors of increased risk (visible haematuria, age, smoking history, male sex, and family history) and reduced risk (previous haematuria investigations, urinary tract infection, dysuria/suprapubic pain, anticoagulation, catheter use, and previous pelvic radiotherapy). The area under the receiver operating characteristic curve of the final model was 0.86 (95% confidence interval 0.85-0.87). The model is limited to patients without previous urological malignancy. CONCLUSIONS: This cancer prediction model is the first to consider established and novel urinary tract cancer diagnostic markers. It can be used in secondary care for risk stratifying patients and aid the clinician's decision-making process in prioritising patients for investigation. PATIENT SUMMARY: We have developed a tool that uses a person's characteristics to determine the risk of cancer if that person develops blood in the urine (haematuria). This can be used to help prioritise patients for further investigation.
dc.language.isoeng
dc.publisherElsevier
dc.rightsCopyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.
dc.rights.urihttp://creativecommons.org/publicdomain/zero/1.0/
dc.subjectBladder cancer
dc.subjectHaematuria
dc.subjectProstate cancer
dc.subjectRenal cancer
dc.subjectRisk Calculator
dc.subjectRisk factors
dc.subjectUrinary tract cancer
dc.subjectUrothelial cancer
dc.titleDeveloping a Diagnostic Multivariable Prediction Model for Urinary Tract Cancer in Patients Referred with Haematuria: Results from the IDENTIFY Collaborative Study
dc.typeJournal Article
dc.identifier.journalEuropean urology focus
dc.description.noteSupports Open Access
dc.type.versionaheadofprint
dc.description.admin-notePublished version, accepted version (12 month embargo)
dc.date.epub2022-06-28


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Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.
Except where otherwise noted, this item's license is described as Copyright © 2022 The Authors. Published by Elsevier B.V. All rights reserved.