Predicting extracorporeal shock wave lithotripsy success with a machine learning nomogram: A pilot study

Result code in IS VaVaI

<a href="https://www.isvavai.cz/riv?ss=detail&h=RIV%2F68407700%3A21340%2F25%3A00388645" target="_blank" >RIV/68407700:21340/25:00388645 - isvavai.cz</a>

Result on the web

<a href="https://doi.org/10.5173/ceju.2025.0104" target="_blank" >https://doi.org/10.5173/ceju.2025.0104</a>

DOI - Digital Object Identifier

<a href="http://dx.doi.org/10.5173/ceju.2025.0104" target="_blank" >10.5173/ceju.2025.0104</a>

Result language

angličtina

Original language name

Predicting extracorporeal shock wave lithotripsy success with a machine learning nomogram: A pilot study

Original language description

Introduction The aim of this pilot study was to develop and validate a machine learning (ML)-based clinical nomogram to predict the success rate of extracorporeal shock wave lithotripsy (ESWL) for kidney stones, optimizing patient selection and treatment outcomes. Material and methods A retrospective analysis of ESWL data in all nephrolithiasis patients was performed from January 2018 to September 2022. Age, gender, stone size, stone area, stone location inside the kidney, stone density, skin-to-stone distance (SSD), stent presence, hydronephrosis presence, complications, and number of ESWL procedures were analysed. Inclusion criteria were a single kidney stone, stone size 5 mm to 20 mm, stone density less than average 1000 HU according to a native CT scan, and an adult patient. Statistical analysis was performed using the T test, mean, and standard deviation, and the calculations were processed using IBM SPSS Statistics for Macintosh, Version 25.0 with statistically significant values indicated by p <0.05. Python programming language was used to test machine learning models based on the previous study data. The scikit-learn library was used as a source of different ML models. Results 102 patients fulfilled inclusion and exclusion criteria. There were 70 male and 32 female patients. The mean age was 54.1 ±13.2 years, mean stone size 9.1 ±3.1 mm, stone area 47.3 ±30.8 mm2 and SSD 8.4 ±1.8 cm. Patients were divided into two groups. The first group consisted of patients who achieved an SFR <=3 mm after single ESWL procedure (group ESWL 1st, n = 42), the second group were patients who needed more than one ESWL procedure to achieve the SFR (group ESWL nth, n = 60). Statistically significant predictors of single-treatment success were stone size (7.9 ±2.2 mm vs 10.0 ±3.4 mm, p <0.001), stone area (34.1 ±19.4 mm(2) vs 56.6 ±33.9 mm(2), p <0.001), and SSD (7.2 ±1.3 cm vs 9.3 ±1.7 cm, p <0.001). The Linear Discriminant Analysis model (LDA) achieved a mean predictive accuracy of ~70%. The final nomogram identified the highest probability of single-treatment ESWL success for SSD <=8 cm and stone area <=60 mm(2), in all locations except for stones in the lower kidney pole. Conclusions Using machine learning we have introduced the nomogram predicting single treatment success rate of an ESWL procedure. The application of this ML-nomogram in clinical practice enables the nomogram to continuously improve and refine its outputs as new data become available.

Czech name

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Czech description

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Type

J_imp - Article in a specialist periodical, which is included in the Web of Science database

CEP classification

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OECD FORD branch

30217 - Urology and nephrology

Project

—

Continuities

I - Institucionalni podpora na dlouhodoby koncepcni rozvoj vyzkumne organizace

Publication year

2025

Confidentiality

S - Úplné a pravdivé údaje o projektu nepodléhají ochraně podle zvláštních právních předpisů

Name of the periodical

Central European Journal of Urology

ISSN

2080-4806

e-ISSN

2080-4873

Volume of the periodical

78

Issue of the periodical within the volume

4

Country of publishing house

PL - POLAND

Number of pages

6

Pages from-to

540-545

UT code for WoS article

001721497100001

EID of the result in the Scopus database

2-s2.0-105026872093