Finding the optimal candidate for shock wave lithotripsy : external validation and comparison of five prediction models
(2023) In Urolithiasis 51(1).- Abstract
We aimed to externally validate five previously published predictive models (Ng score, Triple D score, S3HoCKwave score, Kim nomogram, Niwa nomogram) for shock wave lithotripsy (SWL) single-session outcomes in patients with a solitary stone in the upper ureter. The validation cohort included patients treated with SWL from September 2011 to December 2019 at our institution. Patient-related variables were retrospectively collected from the hospital records. Stone-related data including all measurements were retrieved from computed tomography prior to SWL. We estimated discrimination using area under the curve (AUC), calibration, and clinical net benefit based on decision curve analysis (DCA). A total of 384 patients with... (More)
We aimed to externally validate five previously published predictive models (Ng score, Triple D score, S3HoCKwave score, Kim nomogram, Niwa nomogram) for shock wave lithotripsy (SWL) single-session outcomes in patients with a solitary stone in the upper ureter. The validation cohort included patients treated with SWL from September 2011 to December 2019 at our institution. Patient-related variables were retrospectively collected from the hospital records. Stone-related data including all measurements were retrieved from computed tomography prior to SWL. We estimated discrimination using area under the curve (AUC), calibration, and clinical net benefit based on decision curve analysis (DCA). A total of 384 patients with proximal ureter stones treated with SWL were included in the analysis. Median age was 55.5 years, and 282 (73%) of the sample were men. Median stone length was 8.0 mm. All models significantly predicted the SWL outcomes after one session. S3HoCKwave score, Niwa, and Kim nomograms had the highest accuracy in predicting outcomes, with AUC 0.716, 0.714 and 0.701, respectively. These three models outperformed both the Ng (AUC: 0.670) and Triple D (AUC: 0.667) scoring systems, approaching statistical significance (P = 0.05). Of all the models, the Niwa nomogram showed the strongest calibration and highest net benefit in DCA. To conclude, the models showed small differences in predictive power. The Niwa nomogram, however, demonstrated acceptable discrimination, the most accurate calibration, and the highest net benefit whilst having relatively simple design. Therefore, it could be useful for counselling patients with a solitary stone in the upper ureter.
(Less)
- author
- Popiolek, Marcin ; Jendeberg, Johan ; Sundqvist, Pernilla ; Wagenius, Magnus LU and Lidén, Mats
- organization
- publishing date
- 2023
- type
- Contribution to journal
- publication status
- published
- subject
- keywords
- Nomograms, Outcomes, Shock wave lithotripsy, Ureteral stones, Validation
- in
- Urolithiasis
- volume
- 51
- issue
- 1
- article number
- 66
- publisher
- Springer
- external identifiers
-
- pmid:37027057
- scopus:85152171202
- ISSN
- 2194-7228
- DOI
- 10.1007/s00240-023-01444-4
- language
- English
- LU publication?
- yes
- id
- eeb5078a-f5a3-48a2-afd7-c22c0e50b2d0
- date added to LUP
- 2023-06-20 11:18:55
- date last changed
- 2024-04-20 00:00:59
@article{eeb5078a-f5a3-48a2-afd7-c22c0e50b2d0,
abstract = {{<p>We aimed to externally validate five previously published predictive models (Ng score, Triple D score, S<sub>3</sub>HoCKwave score, Kim nomogram, Niwa nomogram) for shock wave lithotripsy (SWL) single-session outcomes in patients with a solitary stone in the upper ureter. The validation cohort included patients treated with SWL from September 2011 to December 2019 at our institution. Patient-related variables were retrospectively collected from the hospital records. Stone-related data including all measurements were retrieved from computed tomography prior to SWL. We estimated discrimination using area under the curve (AUC), calibration, and clinical net benefit based on decision curve analysis (DCA). A total of 384 patients with proximal ureter stones treated with SWL were included in the analysis. Median age was 55.5 years, and 282 (73%) of the sample were men. Median stone length was 8.0 mm. All models significantly predicted the SWL outcomes after one session. S<sub>3</sub>HoCKwave score, Niwa, and Kim nomograms had the highest accuracy in predicting outcomes, with AUC 0.716, 0.714 and 0.701, respectively. These three models outperformed both the Ng (AUC: 0.670) and Triple D (AUC: 0.667) scoring systems, approaching statistical significance (P = 0.05). Of all the models, the Niwa nomogram showed the strongest calibration and highest net benefit in DCA. To conclude, the models showed small differences in predictive power. The Niwa nomogram, however, demonstrated acceptable discrimination, the most accurate calibration, and the highest net benefit whilst having relatively simple design. Therefore, it could be useful for counselling patients with a solitary stone in the upper ureter.</p>}},
author = {{Popiolek, Marcin and Jendeberg, Johan and Sundqvist, Pernilla and Wagenius, Magnus and Lidén, Mats}},
issn = {{2194-7228}},
keywords = {{Nomograms; Outcomes; Shock wave lithotripsy; Ureteral stones; Validation}},
language = {{eng}},
number = {{1}},
publisher = {{Springer}},
series = {{Urolithiasis}},
title = {{Finding the optimal candidate for shock wave lithotripsy : external validation and comparison of five prediction models}},
url = {{http://dx.doi.org/10.1007/s00240-023-01444-4}},
doi = {{10.1007/s00240-023-01444-4}},
volume = {{51}},
year = {{2023}},
}