Inter-Observer Reliability and Reproducibility of CROES, Guy’s and STONE Nephrolithometry Scoring Systems for Predicting Percutaneous Nephrolithotomy Outcomes
Year 2024,
Volume: 19 Issue: 2, 85 - 89, 29.06.2024
Ali Ayrancı
Ufuk Çağlar
Hakan Cakir
Arda Meriç
Ufuk Can Aksu
Faruk Özgör
Ömer Sarılar
Abstract
Objective: To assess inter-observer reliability and reproducibility of CROES, Guy’s and S.T.O.N.E. nephrolithometry scoring systems (NSS).
Material and Methods: A total of 128 patients who underwent percutaneous nephrolithotomy (PNL) between January 2019 and January 2021 were included in the study. Calculation of the CROES, S.T.O.N.E, and Guy’s NSSs was made by three independent urologists with different academic levels. These were; a very experienced (>500 PCNL cases) endourologist (Rater 1), a urologist who had just finished (>100 PCNL cases) their urology education (Rater 2) and a 3rd year urology resident who had never performed a PCNL operation (Rater 3). All were blinded to the procedure outcomes.
Results: An excellent correlation was found between three raters for Guy and S.T.O.N.E. scoring systems (kappa value 0.810-0.962). However, for the CROES score there is an excellent correlation between Rater 1 and Rater 2, but there were good correlations between Rater 1 vs Rater 3 and Rater 2 vs Rater 3 (kappa values 0.910 and 0.698-0.721 respectively). The highest correlation was between Rater 1 and Rater 2 for Guy score (kappa value 0.962) (Table 3). All intra-class correlations were statistically significant (p<0.001). The highest intra-class correlations were seen for the S.T.O.N.E. score (ICC: 0.980).
Conclusion: The present study revealed that all three NSS frequently used in current urology practice have reproducible and reliable results. Additionally, we believe that the application of CROES NSS by more experienced clinicians will be effective in obtaining clearer results.
References
- Turk C, Neisius A, PEtrik A, Seitz C, Skolarikos A, Thomas K et al. EAU guidelines on urolithiasis. European Association of Urology. https://uroweb.org/guideline/prostate-cancer/ Edn. presented at the EAU Annual Congress Amsterdam 2020. EAU Guidelines Office, Arnhem, The Netherlands. ISBN 978-94-92671-07-3.
- Sfoungaristos S, Mykoniatis I, Isid A, et al. Interobserver Reliability and Reproducibility of the Clinical Research Office of the Endourological Society Nomogram in Predicting Percutaneous Nephrolithotomy Results. Urology. 2016;97:56–60. https://doi.org/10.1016/j.urology.2016.07.014
- Thomas K, Smith NC, Hegarty N, et al. The Guy’s stone score--grading the complexity of percutaneous nephrolithotomy procedures. Urology. 2011;78:277-281. https://doi.org/10,1016/j.urology.2010.12.026
- Okhunov Z, Friedlander JI, George AK, et al. S.T.O.N.E. nephrolithometry: novel surgical classification system for kidney calculi. Urology. 2013;81:1154- 1159. https://doi.org/10.1016/j.urology.2012.10.083
- Smith A, Averch TD, Shahrour K, et al. A nephrolithometric nomogram to predict treatment success of percutaneous nephrolithotomy. J Urol. 2013;190:149-156. https://doi.org/10,1016/j.juro.2013.01.047
- Clavien dindo: Clavien PA, Barkun J, de Oliveira ML et al (2009) The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 250:187-196 https://doi.org/10,1097/SLA.0b013e3181b13ca2
- Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159-174. PMID: 843571
- Cantinotti M, Giordano R, Clemente A, et al. Strengths and Limitations of Current Adult Nomograms for the Aorta Obtained by Noninvasive Cardiovascular Imaging. Echocardiography. 2016;33(7):1046-1068. https://doi.org/10,1111/echo.13232
- Stojadinovic MM, Prelevic RI. External validation of existing nomograms predicting lymph node metastases in cystectomized patients. Int J Clin Oncol. 2015;20(1):164-170. https://doi.org/10.1007/s10147-014-0693-3
- Onal B, Tansu N, Demirkesen O, et al. Nomogram and scoring system for predicting stone-free status after extracorporeal shock wave lithotripsy in children with urolithiasis. BJU Int. 2013;111(2):344-352. https://doi.org/10.1111/j.1464-410X.2012.11281.x
- Ozgor F, Tosun M, Kayali Y, Savun M, Binbay M, Tepeler A. External Validation and Evaluation of Reliability and Validity of the Triple D Score to Predict Stone-Free Status After Extracorporeal Shockwave Lithotripsy. J Endourol. 2017;31(2):169-173. https://doi.org/10.1089/end2016.0721
- Yanaral F, Ozgor F, Savun M, Sahan M, Sarilar O, Binbay M. Comparison of CROES, S.T.O.N.E, and Guy’s scoring systems for the prediction of stone-free status and complication rates following percutaneous nephrolithotomy in patients with chronic kidney disease. Int Urol Nephrol. 2017;49(9):1569-1575. https://doi.org/10.1007/s11255-017-1631-x
- Cantinotti, M., Scalese, M., Giordano, R. et al. A statistical comparison of reproducibility in current pediatric two-dimensional echocardiographic nomograms. Pediatr Res. 89, 579-590 (2021). doi: 10.1038/s41390-020-0900-z.
- Jiang K, Sun F, Zhu J, et al. Evaluation of three stone-scoring systems for predicting SFR and complications after percutaneous nephrolithotomy: a systematic review and meta-analysis. BMC Urol. 2019;19(1):57. https://doi.org/10.1186/s12894-019-0488-y
- Sameera, V., Bindra, A., & Rath, G. P. Human errors and their prevention in healthcare. Journal of anaesthesiology, clinical pharmacology, 2021;37(3):328-335. https://doi.org/10.4103/joacp.JOACP_364_19
- Wang F, Gu X, Chen S, et al. Artificial intelligence system can achieve comparable results to experts for bone age assessment of Chinese children with abnormal growth and development. PeerJ. 2020;8:e8854. https://doi.org/10.7717/peerj.8854
Inter-Observer Reliability and Reproducibility of CROES, Guy’s and STONE Nephrolithometry Scoring Systems for Predicting Percutaneous Nephrolithotomy Outcomes
Year 2024,
Volume: 19 Issue: 2, 85 - 89, 29.06.2024
Ali Ayrancı
Ufuk Çağlar
Hakan Cakir
Arda Meriç
Ufuk Can Aksu
Faruk Özgör
Ömer Sarılar
Abstract
Objective: To assess inter-observer reliability and reproducibility of CROES, Guy’s and S.T.O.N.E. nephrolithometry scoring systems (NSS).
Material and Methods: A total of 128 patients who underwent percutaneous nephrolithotomy (PNL) between January 2019 and January 2021 were included in the study. Calculation of the CROES, S.T.O.N.E, and Guy’s NSSs was made by three independent urologists with different academic levels. These were; a very experienced (>500 PCNL cases) endourologist (Rater 1), a urologist who had just finished (>100 PCNL cases) their urology education (Rater 2) and a 3rd year urology resident who had never performed a PCNL operation (Rater 3). All were blinded to the procedure outcomes.
Results: An excellent correlation was found between three raters for Guy and S.T.O.N.E. scoring systems (kappa value 0.810-0.962). However, for the CROES score there is an excellent correlation between Rater 1 and Rater 2, but there were good correlations between Rater 1 vs Rater 3 and Rater 2 vs Rater 3 (kappa values 0.910 and 0.698-0.721 respectively). The highest correlation was between Rater 1 and Rater 2 for Guy score (kappa value 0.962) (Table 3). All intra-class correlations were statistically significant (p<0.001). The highest intra-class correlations were seen for the S.T.O.N.E. score (ICC: 0.980).
Conclusion: The present study revealed that all three NSS frequently used in current urology practice have reproducible and reliable results. Additionally, we believe that the application of CROES NSS by more experienced clinicians will be effective in obtaining clearer results.
Ethical Statement
Haseki Training and Research Hospital Clinical Research Ethics Committee, Date: 01.02.2023, Protocol: 29-2023.
Supporting Institution
This research did not receive any specific grant from funding agencies in the public, commercial, or not-for-profit sectors.
References
- Turk C, Neisius A, PEtrik A, Seitz C, Skolarikos A, Thomas K et al. EAU guidelines on urolithiasis. European Association of Urology. https://uroweb.org/guideline/prostate-cancer/ Edn. presented at the EAU Annual Congress Amsterdam 2020. EAU Guidelines Office, Arnhem, The Netherlands. ISBN 978-94-92671-07-3.
- Sfoungaristos S, Mykoniatis I, Isid A, et al. Interobserver Reliability and Reproducibility of the Clinical Research Office of the Endourological Society Nomogram in Predicting Percutaneous Nephrolithotomy Results. Urology. 2016;97:56–60. https://doi.org/10.1016/j.urology.2016.07.014
- Thomas K, Smith NC, Hegarty N, et al. The Guy’s stone score--grading the complexity of percutaneous nephrolithotomy procedures. Urology. 2011;78:277-281. https://doi.org/10,1016/j.urology.2010.12.026
- Okhunov Z, Friedlander JI, George AK, et al. S.T.O.N.E. nephrolithometry: novel surgical classification system for kidney calculi. Urology. 2013;81:1154- 1159. https://doi.org/10.1016/j.urology.2012.10.083
- Smith A, Averch TD, Shahrour K, et al. A nephrolithometric nomogram to predict treatment success of percutaneous nephrolithotomy. J Urol. 2013;190:149-156. https://doi.org/10,1016/j.juro.2013.01.047
- Clavien dindo: Clavien PA, Barkun J, de Oliveira ML et al (2009) The Clavien-Dindo classification of surgical complications: five-year experience. Ann Surg. 250:187-196 https://doi.org/10,1097/SLA.0b013e3181b13ca2
- Landis JR, Koch GG. The measurement of observer agreement for categorical data. Biometrics. 1977;33(1):159-174. PMID: 843571
- Cantinotti M, Giordano R, Clemente A, et al. Strengths and Limitations of Current Adult Nomograms for the Aorta Obtained by Noninvasive Cardiovascular Imaging. Echocardiography. 2016;33(7):1046-1068. https://doi.org/10,1111/echo.13232
- Stojadinovic MM, Prelevic RI. External validation of existing nomograms predicting lymph node metastases in cystectomized patients. Int J Clin Oncol. 2015;20(1):164-170. https://doi.org/10.1007/s10147-014-0693-3
- Onal B, Tansu N, Demirkesen O, et al. Nomogram and scoring system for predicting stone-free status after extracorporeal shock wave lithotripsy in children with urolithiasis. BJU Int. 2013;111(2):344-352. https://doi.org/10.1111/j.1464-410X.2012.11281.x
- Ozgor F, Tosun M, Kayali Y, Savun M, Binbay M, Tepeler A. External Validation and Evaluation of Reliability and Validity of the Triple D Score to Predict Stone-Free Status After Extracorporeal Shockwave Lithotripsy. J Endourol. 2017;31(2):169-173. https://doi.org/10.1089/end2016.0721
- Yanaral F, Ozgor F, Savun M, Sahan M, Sarilar O, Binbay M. Comparison of CROES, S.T.O.N.E, and Guy’s scoring systems for the prediction of stone-free status and complication rates following percutaneous nephrolithotomy in patients with chronic kidney disease. Int Urol Nephrol. 2017;49(9):1569-1575. https://doi.org/10.1007/s11255-017-1631-x
- Cantinotti, M., Scalese, M., Giordano, R. et al. A statistical comparison of reproducibility in current pediatric two-dimensional echocardiographic nomograms. Pediatr Res. 89, 579-590 (2021). doi: 10.1038/s41390-020-0900-z.
- Jiang K, Sun F, Zhu J, et al. Evaluation of three stone-scoring systems for predicting SFR and complications after percutaneous nephrolithotomy: a systematic review and meta-analysis. BMC Urol. 2019;19(1):57. https://doi.org/10.1186/s12894-019-0488-y
- Sameera, V., Bindra, A., & Rath, G. P. Human errors and their prevention in healthcare. Journal of anaesthesiology, clinical pharmacology, 2021;37(3):328-335. https://doi.org/10.4103/joacp.JOACP_364_19
- Wang F, Gu X, Chen S, et al. Artificial intelligence system can achieve comparable results to experts for bone age assessment of Chinese children with abnormal growth and development. PeerJ. 2020;8:e8854. https://doi.org/10.7717/peerj.8854