Comparison of the diagnostic utility of CHOKAI, STONE and STONE PLUS scores in predicting ureteral stones larger than 5mm

Abstract The objective of this study is to assess the diagnostic accuracy of CHOKAI, STONE and STONE plus scores in detecting ureteral stones larger than 5 mm. This comparative diagnostic accuracy study was performed in a tertiary care emergency department (ED) and included consecutive patients who presented to the ED with flank pain and underwent ultrasonography and CT over a 1-year period. The performance of these scoring scales in detecting >5 mm ureteral stones was determined by area under the receiver operating characteristics (AUROC) comparison. Ureteral stones were detected in 270 (70.3%) of 384 patients included in the study. While 146 patients (54.1%) had <5mm ureteral stones, 124 patients (54.1%) had stones of 5mm or more in size. The performance of the CHOKAI score in predicting ureteral stones (AUROC 0.903 [95% CI 0.869-0.931]) was superior to the STONE PLUS score (AUROC 0. 879 [95% CI 0.842-0.910]) (p<0.001); STONE PLUS score was also superior to STONE score (AUROC 0.767 [95% CI 0.722-0.809]) (p<0.001). STONE score did not show a statistically significant difference between large and small stone groups (p=0.064). Analysis of the diagnostic value of CHOKAI score (AUROC 0.731 [95% CI 0.684-0.775]) and STONE PLUS scores (AUROC 0.725 [95% CI 0.678-0.769]) in predicting >5 mm stones showed no statistically significant difference (p=0.59). CHOKAI and STONE PLUS scores are useful in predicting >5 mm ureteral stones and have similar diagnostic utility to each other. STONE score does not provide accurate diagnostic information about ureteral stones larger than 5 millimeters.