Format

Send to

Choose Destination
Am J Emerg Med. 2019 Jul 15:158348. doi: 10.1016/j.ajem.2019.07.018. [Epub ahead of print]

External validation of the CHOKAI score for the prediction of ureteral stones: A multicenter prospective observational study.

Author information

1
Department of Urology, Yamagata University Faculty of Medicine, 2-2-2 Iida-nishi, Yamagata City, Yamagata Prefecture 990-9585, Japan. Electronic address: hirokifukuhara@nagoya2.jrc.or.jp.
2
Department of Emergency and Critical Care Medicine, Yamagata University Faculty of Medicine, 2-2-2 Iida-nishi, Yamagata City, Yamagata Prefecture 998-9585, Japan.
3
Department of Urology, Nihonkai General Hospital, 30 Akiho-cho, Sakata City, Yamagata Prefecture 998-8501, Japan.
4
Department of Emergency, Hakodate Municipal Hospital, 1-10-1, Minatomachi, Hakodate City, Hokkaido 041-8680, Japan.
5
Department of Urology, Okitama General Hospital, 2000 Nishi-otsuka, Kawanishi Town, Yamagata Prefecture 992-0601, Japan.
6
Department of Emergency, Yamagata Prefectural Central Hospital, 1800 Aoyagi, Yamagata City, Yamagata Prefecture 990-2292, Japan. Electronic address: asumi.s@med.id.yamagata-u.ac.jp.
7
Department of Urology, Yamagata City Hospital Saiseikan, 1-3-26 Nanokamachi, Yagmagata City, Yamagata Prefecture 990-8533, Japan.
8
Department of Emergency, Kushiro City General Hospital, 1-12 Shunkodai, Kushiro City, Hokkaido 085-0822, Japan.
9
Department of Emergency and Critical Care Medicine, Yamagata University Faculty of Medicine, 2-2-2 Iida-nishi, Yamagata City, Yamagata Prefecture 998-9585, Japan. Electronic address: m-nakane@med.id.yamagata-u.ac.jp.
10
Department of Urology, Yamagata University Faculty of Medicine, 2-2-2 Iida-nishi, Yamagata City, Yamagata Prefecture 990-9585, Japan.

Abstract

OBJECTIVE:

The CHOKAI and STONE scores are clinical prediction rules to predict ureteral stones in patients presenting with renal colic. Both systems contribute to reducing diagnostic radiation exposure; however, few studies have compared the two scoring systems. Therefore, we aimed to compare these systems and assess their diagnostic accuracy for ureteral stones.

METHODS:

This was a multicenter prospective observational study performed between 2017 and 2018, including patients aged >15 years with renal colic and suspected with ureteral stones. We calculated the CHOKAI and STONE scores of each patient based on their medical interviews and physical and laboratory findings. Primary outcome was differences in the area under the receiver operating characteristic curve in each model, and secondary outcome was diagnostic accuracy at the optimal cut-off point.

RESULTS:

Of the 124 patients included, 84 were diagnosed with ureteral stones. The area under the curve of the CHOKAI score was 0.95, showing a sensitivity of 0.93, specificity of 0.90, positive likelihood ratio of 9.3, and negative likelihood ratio of 0.079, at an optimal cut-off point of 6. The area under the curve of the STONE score was 0.88, showing a sensitivity of 0.68, specificity of 0.90, positive likelihood ratio of 6.8, and negative likelihood ratio of 0.36, at an optimal cut-off point of 9. Thus, the area under the curve was significantly higher for the CHOKAI score than for the STONE score (p = 0.0028).

CONCLUSIONS:

The CHOKAI score has a diagnostic performance superior to that of the STONE score in this population.

KEYWORDS:

Clinical prediction rule; Emergency; Renal colic; Ureterolithiasis

PMID:
31337599
DOI:
10.1016/j.ajem.2019.07.018

Supplemental Content

Full text links

Icon for Elsevier Science
Loading ...
Support Center