A systematic review of diagnostic tests and algorithms used in the investigation of haematuria


The aim of this review was to evaluate the efficacy of existing diagnostic algorithms for the investigation of haematuria as reported in the literature; to evaluate the diagnostic accuracy of tests used to detect and investigate haematuria, with a view to informing clinical decision making through the future development of diagnostic algorithms; and to analyze the cost-effectiveness of the investigation of haematuria, in order to develop estimates of the cost-effectiveness of alternative diagnostic strategies.


There were insufficient data available to derive an evidence-based algorithm of the diagnostic pathway for haematuria. A hypothetical algorithm was devised, based on the opinion and practice of clinical experts in the review team, other published algorithms and the results of the economic modelling. The ideas contained in these algorithms and the specific questions outlined should form the basis of future research.

Conducted by: M Rodgers1, J Nixon1, S Hempel1, T Aho2, J Kelly2, D Neal2, S Duffy1, G Ritchie3, J Kleijnen1, M Westwood1

1. Centre for Reviews and Dissemination; 2. Addenbrookes NHS Trust; 3. National Collaborating Centre for Primary Care, London

Further details

Project page on HTA Programme website


Rodgers M , Nixon J, Hempel S, Aho T, Kelly J, Neal D, Duffy S, Kleijnen J, Westwood M.  Diagnostic tests and algorithms used in the investigation of haematuria: systematic reviews and economic evaluation.  Health Technol Assess. 2006; 10(18):1-276

Rodgers MA , Hempel S, Aho T, Kelly JD, Kleijnen J, Westwood M. Diagnostic tests used in the investigation of adult haematuria: a systematic review. BJU Int. 2006;98(6):1154-60


Rodgers M, Nixon J, Hempel S, Aho T, Kelly J, Kleijnen J, Westwood ME. What is the most effective strategy for the investigation of adult haematuria? Health Technology Assessment International (HTAi) Annual Meeting; 2005 May: Rome, Italy


Nixon J, Westwood M, Rodgers M, Hempel S, Kleijnen J, Aho T, Kelly J. The cost-effectiveness of diagnostic strategies to detect haematuria and its underlying causes. Health Technology Assessment International (HTAi) Annual Meeting; 2005 June; Rome, Italy


Commissioned by the HTA Programme