1. External Validation of Outcome Prediction Model for Ureteral/Renal Calculi
- Author
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Sijo J. Parekattil, Patrick Teloken, Stevan B. Streem, Michael E. Moran, Clay Williams, Udaya Kumar, Nicholas J. Hegarty, Mark D. White, Tara Allen, Georges-Pascal Haber, Nelson R. Netto, Arnauld Villers, Charles Ballereau, and Victor A. Leitão
- Subjects
Adult ,Male ,Nephrology ,medicine.medical_specialty ,Ureteral Calculi ,Adolescent ,Urology ,medicine.medical_treatment ,Remission, Spontaneous ,Kidney Calculi ,Ureter ,Internal medicine ,medicine ,Humans ,Cutoff ,Child ,Aged ,Aged, 80 and over ,Receiver operating characteristic ,business.industry ,External validation ,Reproducibility of Results ,Middle Aged ,medicine.disease ,Extracorporeal shock wave lithotripsy ,Surgery ,medicine.anatomical_structure ,Female ,Neural Networks, Computer ,Outcome prediction ,business ,Kidney disease - Abstract
We externally validated a previously designed neural network model to predict outcome and duration of passage for ureteral/renal calculi. The model was also evaluated using a 6 mm largest stone dimension cutoff in predicting stone outcome.The model was previously designed on 301 patients at Albany Medical Center (free shareware from www.uroengineering.com). The model had a prediction accuracy of 86% for passage outcome and 87% for passage duration. In this study we tested the model on a separate 384 patients from 6 different external institutions to assess the prediction accuracy. All patients had a single renal/ureteral calculus by evaluation in an emergency room setting or by primary physicians and were then referred for further treatment. Model accuracy was also compared to using a 6 mm largest stone dimension cutoff in predicting the need for intervention.Testing on the 384 patients from all 6 external institutions revealed an outcome prediction accuracy of 88%. The area under the ROC curve was 0.9. Using a 6 mm stone size cutoff provided 79% (ROC 0.8) accuracy. The model duration of passage prediction accuracy was 80% (133 patients passed the stone, area under ROC of 0.8).The model provided high stone outcome prediction accuracy (ROC of 0.9 and 0.8) at the 6 external institutions, comparable to that of the design institution. The model provided higher accuracy than using only the largest stone dimension as a cutoff. Increasing experience will further assess the model's accuracy.
- Published
- 2006
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