{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,16]],"date-time":"2026-03-16T15:50:32Z","timestamp":1773676232798,"version":"3.50.1"},"reference-count":17,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T00:00:00Z","timestamp":1750204800000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"},{"start":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T00:00:00Z","timestamp":1750204800000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int J of Urology"],"published-print":{"date-parts":[[2025,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objectives<\/jats:title>\n                    <jats:p>To develop a decision curve analysis (DCA)\u2013based risk\u2010adapted strategy that includes risk factors and aids clinical decision\u2010making to avoid unnecessary cystoscopy in patients with primary microscopic hematuria (MH).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Material and Methods<\/jats:title>\n                    <jats:p>Data of 846 consecutive patients who underwent cystoscopy due to microscopic hematuria between September 2022 and April 2024 at a single center were prospectively collected and retrospectively analyzed. MH was defined as 3 or more erythrocytes per magnification in urine analysis. Strategies were developed according to the results of univariate and multivariate analyses. For each strategy, avoided unnecessary cystoscopy and missed bladder tumor ratios were detected. DCA was used to statistically compare the net benefits of each strategy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Tumors were detected in the bladder in 66 patients (7.8%). Multivariate analysis identified smoking status, pack\u2010years of smoking, and advanced age as risk factors for tumor detection, while concurrent lower urinary tract symptoms (LUTS) and a history of recurrent urinary tract infections (UTI)\/prostatitis were associated with a decreased risk. DCA showed that the highest net benefit for detecting tumors in MH was achieved through cystoscopy in patients with &gt;\u200910 pack\u2010years of smoking and\/or no irritative LUTS. The next best strategies involved &gt;\u200910 pack\u2010years of smoking and\/or a history of macroscopic hematuria, and active smoking and\/or no irritative LUTS, respectively.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>DCA\u2010based risk\u2010adapted strategies aid in clinical decision\u2010making and reduce unnecessary interventions in patients scheduled for cystoscopy due to MH. These strategies can guide patients and clinicians regarding the advantages of avoiding cystoscopy and appropriate patient preferences.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/iju.70152","type":"journal-article","created":{"date-parts":[[2025,6,18]],"date-time":"2025-06-18T03:04:32Z","timestamp":1750215872000},"page":"1395-1402","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":1,"title":["Decision Curve Analysis\u2013Based Risk\u2010Adaptive Strategy for Individualizing Cystoscopy Decisions in Patients With Primary Microscopic Hematuria"],"prefix":"10.1111","volume":"32","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0288-8272","authenticated-orcid":false,"given":"Cagri","family":"Akpinar","sequence":"first","affiliation":[{"name":"Department of Urology Ankara University School of Medicine  Ankara Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8219-1151","authenticated-orcid":false,"given":"Samet","family":"Erkartal","sequence":"additional","affiliation":[{"name":"Department of Urology Ankara Etlik City Hospital  Ankara Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-4202-4831","authenticated-orcid":false,"given":"Turker","family":"Soydas","sequence":"additional","affiliation":[{"name":"Department of Urology Ankara Etlik City Hospital  Ankara Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7670-9003","authenticated-orcid":false,"given":"Doruk","family":"Demirel","sequence":"additional","affiliation":[{"name":"Department of Urology Ankara Etlik City Hospital  Ankara Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0670-3044","authenticated-orcid":false,"given":"Ahmet Emin","family":"Dogan","sequence":"additional","affiliation":[{"name":"Department of Urology Ankara Etlik City Hospital  Ankara Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2229-8234","authenticated-orcid":false,"given":"Adem","family":"Sanci","sequence":"additional","affiliation":[{"name":"Department of Urology Ankara Etlik City Hospital  Ankara Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6680-9860","authenticated-orcid":false,"given":"Ahmet Nihat","family":"Karakoyunlu","sequence":"additional","affiliation":[{"name":"Department of Urology Ankara Etlik City Hospital  Ankara Turkey"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,6,18]]},"reference":[{"key":"e_1_2_12_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0022-5347(17)40763-4"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2012.09.078"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2018.04.065"},{"key":"e_1_2_12_5_1","doi-asserted-by":"publisher","DOI":"10.1097\/JU.0000000000001297"},{"key":"e_1_2_12_6_1","doi-asserted-by":"publisher","DOI":"10.1080\/14737140.2017.1284589"},{"key":"e_1_2_12_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.euf.2022.06.001"},{"key":"e_1_2_12_8_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.juro.2010.12.093"},{"key":"e_1_2_12_9_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urolonc.2017.09.011"},{"key":"e_1_2_12_10_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2021.04.031"},{"key":"e_1_2_12_11_1","doi-asserted-by":"publisher","DOI":"10.1111\/ijcp.14662"},{"issue":"11","key":"e_1_2_12_12_1","first-page":"747","article-title":"Assessment of Asymptomatic Microscopic Hematuria in Adults","volume":"88","author":"Sharp V. 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