Micro-cost analysis of reusable compared to affordable single-use flexible ureteroscopes
Bibliographic record
Abstract
INTRODUCTION: Flexible ureteroscopy is increasingly used for managing upper urinary tract pathologies, particularly kidney stones. With the emergence of affordable, single-use flexible ureteroscopes (fURS) as an alternative to reusable systems, the contemporary economic impact of each device is unclear. We performed a micro-cost evaluation comparing reusable fURS with two single-use models in a single-payer, Canadian healthcare system. METHODS: The costs of reusable fURS were divided into acquisition, repair, and reprocessing expenses. Per-procedure costs for reusable fURS were calculated by dividing the total annual costs by the average annual number of procedures, whereas single-use costs were based solely on device prices. The total number of repairs and specific reasons for repairs were also collected for the entire reusable fURS fleet from 2022-2024. RESULTS: At our center, an average of 418 procedures were performed annually using reusable fURS, with total annual costs of $102 420.60, equaling to $245.03 per procedure. Reusable fURS become more cost-effective at volumes exceeding 130 cases compared to EU-Scope™ US 31E-12 and 83 cases compared to the Standard LithoVue™. Additionally, 65 repair events were recorded from 2022-2024, mainly due to distal tip leakage (77%). One repair was required for roughly 20 procedures (20.22:1). CONCLUSIONS: Our analysis indicates that reusable systems are more cost-efficient in high-volume settings, while single-use devices, especially the EU-Scope™, may be advantageous in lower-volume centers. In tertiary centers, the use of single-use fURS represents an excellent opportunity to preserve the durability of reusable fURS, particularly during complex procedures with a high risk of ureteroscope damage.
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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 | 0.003 | 0.015 |
| Meta-epidemiology (narrow) | 0.001 | 0.000 |
| Meta-epidemiology (broad) | 0.001 | 0.003 |
| Bibliometrics | 0.004 | 0.004 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.002 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.003 | 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".