Department of Urology, Yamagata University Faculty of Medicine, 2-2-2 Iida-nishi, Yamagata City, Yamagata Prefecture 990-9585, Japan.
Department of Emergency and Critical Care Medicine, Yamagata University Faculty of Medicine, 2-2-2 Iida-nishi, Yamagata City, Yamagata Prefecture 998-9585, Japan.
Am J Emerg Med. 2020 May;38(5):920-924. doi: 10.1016/j.ajem.2019.07.018. Epub 2019 Jul 15.
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.
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.
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).
The CHOKAI score has a diagnostic performance superior to that of the STONE score in this population.
CHOKAI 和 STONE 评分是用于预测肾绞痛患者输尿管结石的临床预测规则。这两个系统都有助于减少诊断辐射暴露；然而，很少有研究比较这两种评分系统。因此，我们旨在比较这两种系统，并评估它们对输尿管结石的诊断准确性。
这是一项多中心前瞻性观察研究，于 2017 年至 2018 年进行，纳入年龄>15 岁的肾绞痛且疑似输尿管结石的患者。我们根据每位患者的医疗访谈、体格检查和实验室检查结果计算 CHOKAI 和 STONE 评分。主要结局是比较每个模型的受试者工作特征曲线下面积的差异，次要结局是最佳截断点的诊断准确性。
在纳入的 124 例患者中，84 例被诊断为输尿管结石。CHOKAI 评分的曲线下面积为 0.95，灵敏度为 0.93，特异性为 0.90，阳性似然比为 9.3，阴性似然比为 0.079，最佳截断点为 6。STONE 评分的曲线下面积为 0.88，灵敏度为 0.68，特异性为 0.90，阳性似然比为 6.8，阴性似然比为 0.36，最佳截断点为 9。因此，CHOKAI 评分的曲线下面积显著高于 STONE 评分（p=0.0028）。
在该人群中，CHOKAI 评分的诊断性能优于 STONE 评分。
