Post-Ureteroscopic Lesion Scale to determine ureteral wall damage, not so easy to employ

Objective: To analyze the level of agreement of the Post-Ureteroscopic Lesion Scale (PULS) and the consequences on its application in clinical practice with more reliable statistical data than the one used in the original work. Methods: 14 URS and 14 micro-URS were performed in 14 female porcine mod...

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Detalles Bibliográficos
Autores: Polo, R, Canós-Nebot, A, Caballero-Romeu, JP, Caballero, P, Galán-Llopis, JA, Soria, F, de la Cruz-conty, JE, Tuells, J
Tipo de recurso: artículo
Estado:Versión publicada
Fecha de publicación:2024
País:España
Institución:Instituto de Investigación Biomédica y Sanitaria de Alicante (ISABIAL)
Repositorio:r-ISABIAL. Repositorio Institucional de Producción Científica del Instituto de Investigación Biomédica y Sanitaria de Alicante
OAI Identifier:oai:isabial.fundanetsuite.com:p10476
Acceso en línea:https://isabial.portalinvestigacion.com/publicaciones10476
https://www.sciencedirect.com/science/article/pii/S0210480623001304?via%3Dihub
Access Level:acceso abierto
Palabra clave:Ureteral lesion
Scale
Concordance
Ureteroscopy
Micro-ureteroscopy
Post-Ureteroscopic Lesion Scale
Descripción
Sumario:Objective: To analyze the level of agreement of the Post-Ureteroscopic Lesion Scale (PULS) and the consequences on its application in clinical practice with more reliable statistical data than the one used in the original work. Methods: 14 URS and 14 micro-URS were performed in 14 female porcine model. All the procedures were video recorded and an anatomopathological analysis was performed in each ureter. Sixteen urologists (9 endourologists and 7 general urologists) and 4 residents evaluated the ureteral lesions according to the PULS, with degrees 0, 1 and >= 2. The agreement was calculated with percentages, Kendall's W coefficient and the indicators Fleiss' Kappa and Krippendorff's Alpha, while the inter -rater agreement was calculated with Spearman's correlation and Cohen's Kappa. Results: The percent of agreement was 11.1%. The coefficients were likewise classified as low or very low, with the greatest agreement found among the inexperienced. Also, 50% of the raters did not agree with the rest. Conclusions: The low inter -rater agreement, the specificity of the PULS and the clinicalpathological correlation suggests that this scale is not simple, and probably has a long learning curve. (c) 2023 The Authors. Published by Elsevier Espa & ntilde;a, S.L.U. on behalf of AEU. This is an open access article under the CC BY -NC -ND license (http://creativecommons.org/licenses/by-nc-nd/4.0/).