PURPOSE To develop and validate a new clinical prediction model that accurately predicts the failure of shockwave lithotripsy (SWL) using information obtained from non-contrast-enhanced computed tomography (NCCT). METHODS This multicentre retrospective cohort study consecutively enrolled patients diagnosed with upper urinary tract calculi by NCCT at five hospitals in Japan from January 1, 2006 to December 31, 2016. Among the candidate predictors, we selected the six most significant predictors a priori. The main outcome was SWL failure after three sessions. Model calibration was evaluated by the calibration slope and the Hosmer-Lemeshow test. Discrimination was evaluated by the receiver-operating characteristic curves and the area under the curve (AUC). A multivariable logistic regression analysis was performed; based on the estimated β coefficients, predictive scores were generated. RESULTS Of 2695 patients, 2271 were included. Patients were divided into the development cohort (1666 patients) and validation cohort (605 patients) according to geographical factors. We developed a clinical prediction model with scores ranging from 0 to 49 points. We named the prediction model the S3HoCKwave score based on the initials of the predictors (sex, skin-to-stone distance, size, Hounsfield units, colic, and kidney or ureter). As a result of internal validation, the optimism-corrected AUC was 0.72. In the validation cohort, the Hosmer-Lemeshow test did not show statistical significance (P = 0.33), and the AUC was 0.71 (95% confidence interval 0.65-0.76). CONCLUSIONS The S3HoCKwave score is easy to understand, has a relatively high predictive value, and allows clinicians to make appropriate treatment selections.

中文翻译：

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使用计算机断层扫描信息：S3HoCKwave评分，开发和验证上尿路结石的冲击波碎石失败的预测模型。

目的开发和验证一种新的临床预测模型，该模型将使用从非增强CT扫描中获得的信息准确预测冲击波碎石术（SWL）的失败。方法该多中心回顾性队列研究从2006年1月1日至2016年12月31日在日本的五家医院连续纳入了通过NCCT诊断为上尿路结石的患者。在候选预测变量中，我们选择了六个最重要的预测变量进行先验。主要结果是三个疗程后SWL失败。通过校准斜率和Hosmer-Lemeshow测试评估模型校准。通过接收器操作特性曲线和曲线下面积（AUC）来评估辨别力。进行了多元逻辑回归分析；基于估计的β系数，生成预测分数。结果2695名患者中，包括2271名。根据地理因素将患者分为发展队列（1666例）和验证队列（605例）。我们开发了一个临床预测模型，其评分范围为0到49分。我们根据预测变量的缩写（性别，皮肤到石头的距离，大小，Hounsfield单位，绞痛以及肾脏或输尿管）将预测模型命名为S3HoCKwave得分。内部验证的结果是，乐观校正后的AUC为0.72。在验证队列中，Hosmer-Lemeshow检验未显示统计学显着性（P = 0.33），AUC为0.71（95％置信区间0.65-0.76）。结论S3HoCKwave得分易于理解，具有较高的预测价值，