External Validation of the STONE Score, a Clinical Prediction Rule for Ureteral Stone: An Observational Multi-institutional Study
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Le résumé fourni par la source
STUDY OBJECTIVE: The STONE score is a clinical decision rule that classifies patients with suspected nephrolithiasis into low-, moderate-, and high-score groups, with corresponding probabilities of ureteral stone. We evaluate the STONE score in a multi-institutional cohort compared with physician gestalt and hypothesize that it has a sufficiently high specificity to allow clinicians to defer computed tomography (CT) scan in patients with suspected nephrolithiasis. METHODS: We assessed the STONE score with data from a randomized trial for participants with suspected nephrolithiasis who enrolled at 9 emergency departments between October 2011 and February 2013. In accordance with STONE predictors, we categorized participants into low-, moderate-, or high-score groups. We determined the performance of the STONE score and physician gestalt for ureteral stone. RESULTS: Eight hundred forty-five participants were included for analysis; 331 (39%) had a ureteral stone. The global performance of the STONE score was superior to physician gestalt (area under the receiver operating characteristic curve=0.78 [95% confidence interval {CI} 0.74 to 0.81] versus 0.68 [95% CI 0.64 to 0.71]). The prevalence of ureteral stone on CT scan ranged from 14% (95% CI 9% to 19%) to 73% (95% CI 67% to 78%) in the low-, moderate-, and high-score groups. The sensitivity and specificity of a high score were 53% (95% CI 48% to 59%) and 87% (95% CI 84% to 90%), respectively. CONCLUSION: The STONE score can successfully aggregate patients into low-, medium-, and high-risk groups and predicts ureteral stone with a higher specificity than physician gestalt. However, in its present form, the STONE score lacks sufficient accuracy to allow clinicians to defer CT scan for suspected ureteral stone.
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Le contrôle bibliographique ouvert
DOI retrouvé dans Crossref DOI retrouvé ; titre concordant.
- Titre Crossref
- External Validation of the STONE Score, a Clinical Prediction Rule for Ureteral Stone: An Observational Multi-institutional Study
- Date Crossref
- 01/04/2016
- Éditeur
- Elsevier BV
- Type
- journal-article
Ce recoupement confirme des métadonnées liées au DOI. Il ne confirme ni la méthode ni les conclusions de l’étude, et il ne compte pas comme une seconde source scientifique indépendante.
Où se fait cette recherche
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University of California Department of Emergency Medicine pays non établi dans la noticeUniversité ou école supérieure
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Massachusetts General Hospital Department of Emergency Medicine pays non établi dans la noticeÉtablissement de santé
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Jr. Hospital of Cook County John H. Stroger pays non établi dans la noticeÉtablissement de santé
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University of Utah Division of Emergency Medicine pays non établi dans la noticeUniversité ou école supérieure
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Jacobi Medical Center pays non établi dans la noticeÉtablissement de santé
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University of Southern California Department of Emergency Medicine pays non établi dans la noticeUniversité ou école supérieure
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Albert Einstein College of Medicine Department of Emergency Medicine pays non établi dans la noticeUniversité ou école supérieure
Department of Emergency Medicine — University of California, Department of Emergency Medicine — Massachusetts General Hospital et John H. Stroger — Jr. Hospital of Cook County, avec 4 autres affiliations.
Une affiliation ne permet pas de déduire la nationalité d’un auteur.