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Scoring System Reliably Predicts the Presence of Uncomplicated Ureteral Stones — Physician’s First Watch

Medical News |
April 17, 2014

Scoring System Reliably Predicts the Presence of Uncomplicated Ureteral Stones

By Amy Orciari Herman

A new scoring system based on five risk factors can predict which patients have uncomplicated ureteral stones and, ultimately, may reduce imaging use, a BMJ study finds.

Using a retrospective cohort of some 1000 adults undergoing CT scans for flank pain in two emergency departments, researchers identified five factors most significantly associated with ureteral stones: male sex, acute onset of pain, non-black race, nausea or vomiting, and microscopic hematuria. These factors, considered together, formed the STONE score (range, 0-13 points).

The researchers then tested the score in a prospective cohort of some 500 patients: just 9% of those with low-probability scores had kidney stones, versus 51% with moderate scores and 89% with high scores. Only 1% of the high-score group had acutely important alternative findings on CT.

The authors write that the score may be used in certain situations — and particularly among younger patients — to avoid CT. For example, if the score is high, they write, "a CT might be avoided entirely or a reduced dose CT could be performed."

Reader Comments (2)

THOMAS KLINE

Good Lord! Have people stopped going to medical school?
These classical symptoms and signs have been around
for 100 years.

Thomas Kline MD

* Other, Internal Medicine, Split University School of Medicine

The STONE score evidently reiterates the classic history points. I don't see any advantage in following it. Instead of filling more forms/questionnaires on your computer just keep taking good histories and don't forget the appropriate communication with your patients!

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