Moderated Poster Session IV: Stones/Endourology/BPH/Infertility/General
Bibliographic record
Abstract
Background: Uric acid nephrolithiasis (UAn) comprises 8-10% of all kidney stones in the United States.Three significant urinary abnormalities have been described as the main etiological factors for the development of UAn: low urinary pH, hyperuricosuria and low urinary volume.To better understand the quality of care delivered to this patient population, we reviewed the medical and surgical treatment, compliance, and clinical outcomes of an institutional UAn cohort.Methods: A retrospective study of a 24-hour urine collection database of all hyperuricosuric patients that attended our stone clinic from 2000 to 2014 was performed.Patient's charts were reviewed for demographic data, medical management, medication compliance, emergency department (ED) visits for renal colic, surgical intervention, and 24-hour urine data. Results:We identified 614 patients with hyperuricosuria, of which, 45 patients (11 female) had stone data analysis available confirming UAn.Average uric acid stone composition was 63.4% (5-100%).The mean age at presentation was 55.4 years (32 to 77 years).Average patient follow up was 3.8 years (up to 11.9 years), and was seen on average every 7.2 months at our designated stone clinic.Of all the patients, 73.3% were diagnosed of having UAn after a procedure was performed to render them stone free, the remainder where referred to clinic after spontaneous passage of a stone.A total of 116 endourologic procedures were performed.Females underwent an average of 4 procedures versus 2.7 procedures in their male counterparts.65 emergency department visits were recorded for renal colic; 84.6% occurred in those patients eventually requiring a surgical procedure, whereas only 15.4% occurred in those who spontaneously had stone passage.Postoperatively, patients were treated with potassium citrate and/or sodium bicarbonate for urine alkalization at 89.2% and 13.5%, respectively.All patients receiving alkalization therapy experienced uric acid stone recurrence prompting investigation for treatment compliance.Follow-up in a dedicated stone clinic only resulted in 55.6% of patients repeating their 24-hour urine collections.Of those, trends where seen but they were not statistically significant: volume increase 160 mL (2.19L to 2.35L), pH increase 0.075 (5.68 to 5.76), and uric acid decreased by 0.065 g/day (0.976 g/day to 0.911 g/day).Conclusions: Despite a comprehensive stone clinic, patients had only modest improvements in 24-hour urine parameters and had relatively high recurrence rate.Compliance with treatment was low.UAn patient's treatment compliance remains a challenge and an opportunity for quality improvement.
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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) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.003 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.569 | 0.294 |
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".