Third Prize: Contemporary Percutaneous Nephrolithotripsy: 1585 Procedures in 1338 Consecutive Patients
Bibliographic record
Abstract
BACKGROUND AND PURPOSE: The approach to urinary-stone disease has changed dramatically over the last three decades with a transition from open surgery to minimally invasive procedures. Percutaneous nephrolithotripsy (PCNL) is a cornerstone of the treatment of kidney and selected upper-ureteral stones and continues to evolve with advances in techniques and instrumentation. The purpose of this study was to assess outcomes and trends prospectively in a large contemporary group of patients undergoing PCNL. PATIENTS AND METHODS: Between July 1990 and December 2005, all 1338 patients at a single center scheduled for PCNL (N = 1585 procedures) were enrolled. Their mean age was 53 years (range 4-89 years). Data including comorbidities, stone burden, stone location, surgical time, hospital length of stay, rate of secondary procedures, and adverse events were collected prospectively. The primary outcome measures were stone-free rate and complications. RESULTS: There was a substantial incidence of comorbid medical conditions (48.8%) and anatomic renal abnormalities (25.3%), demonstrating the diverse and challenging patient population in this contemporary series. The overall stone-free rate at 3 to 6 months of follow-up was 94.8%. CONCLUSIONS: Percutaneous nephrolithotripsy is a highly effective procedure and may be performed in a diverse group of patients with comorbid conditions and renal abnormalities. Improved intracorporeal lithotripters, balloon dilation of the tract, use of flexible instruments, and liberal use of secondary nephroscopy result in excellent stone-free rates with low morbidity.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.002 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".