Evidence map›Paper›PMID 35947709›Full record

Trial reportThe New England journal of medicine2022

Removal of Small, Asymptomatic Kidney Stones and Incidence of Relapse.

Mathew D Sorensen, Jonathan D Harper, Michael S Borofsky, Tariq A Hameed, Kimberly J Smoot, Barbara H Burke, Branda J Levchak, James C Williams, Michael R Bailey, Ziyue Liu and 1 more

Registry-linked trialOpen access · bronzeAbstract readMulticenter StudyRandomized Controlled Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The New England journal of medicine, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02210650 (Randomized Controlled Trial Comparing Relapse Rates Between Standard Ureteroscopic Removal Of Ureteral Stone And Standard Removal With Additional Ureterorenic Clearing Of Non-Symptomatic Stones In The Kidney), which is not on this map. Cited by 34 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
34citing papers in PubMed, 2 pooled it
10.2field-weighted citation impact, top 1% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT02210650 nacompletednot on this map

Randomized Controlled Trial Comparing Relapse Rates Between Standard Ureteroscopic Removal Of Ureteral Stone And Standard Removal With Additional Ureterorenic Clearing Of Non-Symptomatic Stones In The Kidney

TypeinterventionalSponsorIndiana Kidney Stone InstituteRan2014 to 2022Enrolled75ConditionsUreteral Stones, Kidney StonesArmsSymptomatic stone removal, Asymptomatic kidney stones and ureteral stone removed
3 · Its place in the literature

Who cites it

34 citing papers in PubMed, 2 syntheses or guidelines pooled it, 67 citations in OpenAlex.

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4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

11 authors at 6 institutions in 1 country.

Mathew D SorensenFrom the Department of Urology, University of Washington School of Medicine (M.D.S., J.D.H.), the Division of Urology (M.D.S., M.R.B.) and the Seattle Institute for Biomedical and Clinical Research (B.J.L.), Veterans Affairs Puget Sound Health Care System, and the Institute of Translational Health Sciences (B.H.B.) and the Center for Industrial and Medical Ultrasound, Applied Physics Laboratory (M.R.B.), University of Washington - all in Seattle; the Department of Urology, University of Minnesota, Minneapolis (M.S.B.); and the Departments of Radiology and Imaging Sciences (T.A.H.), Urology (K.J.S., J.E.L.), Cell Biology and Physiology (J.C.W.), and Biostatistics and Health Data Science (Z.L.), Indiana University School of Medicine, Indianapolis.
Jonathan D HarperFrom the Department of Urology, University of Washington School of Medicine (M.D.S., J.D.H.), the Division of Urology (M.D.S., M.R.B.) and the Seattle Institute for Biomedical and Clinical Research (B.J.L.), Veterans Affairs Puget Sound Health Care System, and the Institute of Translational Health Sciences (B.H.B.) and the Center for Industrial and Medical Ultrasound, Applied Physics Laboratory (M.R.B.), University of Washington - all in Seattle; the Department of Urology, University of Minnesota, Minneapolis (M.S.B.); and the Departments of Radiology and Imaging Sciences (T.A.H.), Urology (K.J.S., J.E.L.), Cell Biology and Physiology (J.C.W.), and Biostatistics and Health Data Science (Z.L.), Indiana University School of Medicine, Indianapolis.
Michael S BorofskyFrom the Department of Urology, University of Washington School of Medicine (M.D.S., J.D.H.), the Division of Urology (M.D.S., M.R.B.) and the Seattle Institute for Biomedical and Clinical Research (B.J.L.), Veterans Affairs Puget Sound Health Care System, and the Institute of Translational Health Sciences (B.H.B.) and the Center for Industrial and Medical Ultrasound, Applied Physics Laboratory (M.R.B.), University of Washington - all in Seattle; the Department of Urology, University of Minnesota, Minneapolis (M.S.B.); and the Departments of Radiology and Imaging Sciences (T.A.H.), Urology (K.J.S., J.E.L.), Cell Biology and Physiology (J.C.W.), and Biostatistics and Health Data Science (Z.L.), Indiana University School of Medicine, Indianapolis.
Tariq A HameedFrom the Department of Urology, University of Washington School of Medicine (M.D.S., J.D.H.), the Division of Urology (M.D.S., M.R.B.) and the Seattle Institute for Biomedical and Clinical Research (B.J.L.), Veterans Affairs Puget Sound Health Care System, and the Institute of Translational Health Sciences (B.H.B.) and the Center for Industrial and Medical Ultrasound, Applied Physics Laboratory (M.R.B.), University of Washington - all in Seattle; the Department of Urology, University of Minnesota, Minneapolis (M.S.B.); and the Departments of Radiology and Imaging Sciences (T.A.H.), Urology (K.J.S., J.E.L.), Cell Biology and Physiology (J.C.W.), and Biostatistics and Health Data Science (Z.L.), Indiana University School of Medicine, Indianapolis.
Kimberly J SmootFrom the Department of Urology, University of Washington School of Medicine (M.D.S., J.D.H.), the Division of Urology (M.D.S., M.R.B.) and the Seattle Institute for Biomedical and Clinical Research (B.J.L.), Veterans Affairs Puget Sound Health Care System, and the Institute of Translational Health Sciences (B.H.B.) and the Center for Industrial and Medical Ultrasound, Applied Physics Laboratory (M.R.B.), University of Washington - all in Seattle; the Department of Urology, University of Minnesota, Minneapolis (M.S.B.); and the Departments of Radiology and Imaging Sciences (T.A.H.), Urology (K.J.S., J.E.L.), Cell Biology and Physiology (J.C.W.), and Biostatistics and Health Data Science (Z.L.), Indiana University School of Medicine, Indianapolis.
Barbara H BurkeFrom the Department of Urology, University of Washington School of Medicine (M.D.S., J.D.H.), the Division of Urology (M.D.S., M.R.B.) and the Seattle Institute for Biomedical and Clinical Research (B.J.L.), Veterans Affairs Puget Sound Health Care System, and the Institute of Translational Health Sciences (B.H.B.) and the Center for Industrial and Medical Ultrasound, Applied Physics Laboratory (M.R.B.), University of Washington - all in Seattle; the Department of Urology, University of Minnesota, Minneapolis (M.S.B.); and the Departments of Radiology and Imaging Sciences (T.A.H.), Urology (K.J.S., J.E.L.), Cell Biology and Physiology (J.C.W.), and Biostatistics and Health Data Science (Z.L.), Indiana University School of Medicine, Indianapolis.
Branda J LevchakFrom the Department of Urology, University of Washington School of Medicine (M.D.S., J.D.H.), the Division of Urology (M.D.S., M.R.B.) and the Seattle Institute for Biomedical and Clinical Research (B.J.L.), Veterans Affairs Puget Sound Health Care System, and the Institute of Translational Health Sciences (B.H.B.) and the Center for Industrial and Medical Ultrasound, Applied Physics Laboratory (M.R.B.), University of Washington - all in Seattle; the Department of Urology, University of Minnesota, Minneapolis (M.S.B.); and the Departments of Radiology and Imaging Sciences (T.A.H.), Urology (K.J.S., J.E.L.), Cell Biology and Physiology (J.C.W.), and Biostatistics and Health Data Science (Z.L.), Indiana University School of Medicine, Indianapolis.
James C WilliamsFrom the Department of Urology, University of Washington School of Medicine (M.D.S., J.D.H.), the Division of Urology (M.D.S., M.R.B.) and the Seattle Institute for Biomedical and Clinical Research (B.J.L.), Veterans Affairs Puget Sound Health Care System, and the Institute of Translational Health Sciences (B.H.B.) and the Center for Industrial and Medical Ultrasound, Applied Physics Laboratory (M.R.B.), University of Washington - all in Seattle; the Department of Urology, University of Minnesota, Minneapolis (M.S.B.); and the Departments of Radiology and Imaging Sciences (T.A.H.), Urology (K.J.S., J.E.L.), Cell Biology and Physiology (J.C.W.), and Biostatistics and Health Data Science (Z.L.), Indiana University School of Medicine, Indianapolis.
Michael R BaileyFrom the Department of Urology, University of Washington School of Medicine (M.D.S., J.D.H.), the Division of Urology (M.D.S., M.R.B.) and the Seattle Institute for Biomedical and Clinical Research (B.J.L.), Veterans Affairs Puget Sound Health Care System, and the Institute of Translational Health Sciences (B.H.B.) and the Center for Industrial and Medical Ultrasound, Applied Physics Laboratory (M.R.B.), University of Washington - all in Seattle; the Department of Urology, University of Minnesota, Minneapolis (M.S.B.); and the Departments of Radiology and Imaging Sciences (T.A.H.), Urology (K.J.S., J.E.L.), Cell Biology and Physiology (J.C.W.), and Biostatistics and Health Data Science (Z.L.), Indiana University School of Medicine, Indianapolis.ORCID 0000-0003-0491-6465
Ziyue LiuFrom the Department of Urology, University of Washington School of Medicine (M.D.S., J.D.H.), the Division of Urology (M.D.S., M.R.B.) and the Seattle Institute for Biomedical and Clinical Research (B.J.L.), Veterans Affairs Puget Sound Health Care System, and the Institute of Translational Health Sciences (B.H.B.) and the Center for Industrial and Medical Ultrasound, Applied Physics Laboratory (M.R.B.), University of Washington - all in Seattle; the Department of Urology, University of Minnesota, Minneapolis (M.S.B.); and the Departments of Radiology and Imaging Sciences (T.A.H.), Urology (K.J.S., J.E.L.), Cell Biology and Physiology (J.C.W.), and Biostatistics and Health Data Science (Z.L.), Indiana University School of Medicine, Indianapolis.
James E LingemanFrom the Department of Urology, University of Washington School of Medicine (M.D.S., J.D.H.), the Division of Urology (M.D.S., M.R.B.) and the Seattle Institute for Biomedical and Clinical Research (B.J.L.), Veterans Affairs Puget Sound Health Care System, and the Institute of Translational Health Sciences (B.H.B.) and the Center for Industrial and Medical Ultrasound, Applied Physics Laboratory (M.R.B.), University of Washington - all in Seattle; the Department of Urology, University of Minnesota, Minneapolis (M.S.B.); and the Departments of Radiology and Imaging Sciences (T.A.H.), Urology (K.J.S., J.E.L.), Cell Biology and Physiology (J.C.W.), and Biostatistics and Health Data Science (Z.L.), Indiana University School of Medicine, Indianapolis.
Seattle Institute for Biomedical and Clinical Research · USUniversity of Washington · USIndiana University Health · USUniversity of Minnesota · USUniversity of Puget Sound · USVA Puget Sound Health Care System · US

Funding

SWL AND RENAL INJURY AND STONE COMMINUTIONP01DK043881 · NIDDK · UNIVERSITY OF WASHINGTON · PI BAILEY, MICHAEL R · 1994 to 2023
$33.5M
NIDDK NIH HHS P01 DK043881
6 · The paper itself

Abstract

backgroundThe benefits of removing small (≤6 mm), asymptomatic kidney stones endoscopically is unknown. Current guidelines leave such decisions to the urologist and the patient. A prospective study involving older, nonendoscopic technology and some retrospective studies favor observation. However, published data indicate that about half of small renal stones left in place at the time that larger stones were removed caused other symptomatic events within 5 years after surgery.

methodsWe conducted a multicenter, randomized, controlled trial in which, during the endoscopic removal of ureteral or contralateral kidney stones, remaining small, asymptomatic stones were removed in 38 patients (treatment group) and were not removed in 35 patients (control group). The primary outcome was relapse as measured by future emergency department visits, surgeries, or growth of secondary stones.

resultsAfter a mean follow-up of 4.2 years, the treatment group had a longer time to relapse than the control group (P<0.001 by log-rank test). The restricted mean (±SE) time to relapse was 75% longer in the treatment group than in the control group (1631.6±72.8 days vs. 934.2±121.8 days). The risk of relapse was 82% lower in the treatment group than the control group (hazard ratio, 0.18; 95% confidence interval, 0.07 to 0.44), with 16% of patients in the treatment group having a relapse as compared with 63% of those in the control group. Treatment added a median of 25.6 minutes (interquartile range, 18.5 to 35.2) to the surgery time. Five patients in the treatment group and four in the control group had emergency department visits within 2 weeks after surgery. Eight patients in the treatment group and 10 in the control group reported passing kidney stones.

conclusionsThe removal of small, asymptomatic kidney stones during surgery to remove ureteral or contralateral kidney stones resulted in a lower incidence of relapse than nonremoval and in a similar number of emergency department visits related to the surgery. (Funded by the National Institute of Diabetes and Digestive and Kidney Diseases and the Veterans Affairs Puget Sound Health Care System; ClinicalTrials.gov number, NCT02210650.).

Indexed as

EndoscopyKidney CalculiSecondary PreventionUreteral CalculiChronic DiseaseHumansIncidenceRecurrenceUreteroscopy

Identifiers

PMID35947709
PMCPMC9741871
OpenAlexW4291020619

What OpenQuestion holds

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Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.