A comparative analysis of surgical trends in upper urinary tract stone management in Ontario, Canada, and Israel
Bibliographic record
Abstract
Objective: To compare trends and incidence of surgical intervention among adults with urolithiasis in Ontario, Canada, and Israel. Patients and methods: A retrospective analysis was conducted using administrative databases from Clalit Health Service in Israel and IC/ES in Canada. The study included adults who underwent their initial surgical treatment for urolithiasis. Descriptive statistics summarized baseline patient demographics, while comparisons were analyzed with a t -test. Results: Between 2003 and 2018, 31,034 and 105,013 patients who underwent surgical intervention for upper urinary tract stones for the first time in their clinical history, excluding those with prior surgical treatments for the same condition, in Israel and Ontario, respectively. The number of insured at Clalit Health Services increased by 21.3%, while the population in Ontario grew by 18.5%. The total number of treated cases rose by 82% and 64.4% in Israel and Ontario, respectively. The procedures per 100,000 people increased by 51% in Israel and 34.6% in Ontario. In Israel, the proportion of females undergoing surgery decreased from 33.5% to 32%, while in Ontario, it increased from 36.3% to 49.8%. Ureteroscopy (URS) was more commonly used in Ontario, while shock wave lithotripsy (SWL) was more common in Israel. URS utilization surged by 281% in Israel and 145.5% in Ontario. Percutaneous nephrolithotripsy (PCNL) increased by 52% in Israel and 8.6% in Ontario, while SWL procedures declined by 57% in Israel and 32.5% in Ontario. Conclusions: A significant rise in the number of patients undergoing their first stone-related procedure in both regions, particularly in Israel. There was a difference in the proportion of female patients requiring surgical intervention, with an increase in Ontario and a decrease in Israel.
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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) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.005 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
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".