To review the status of comparative effectiveness studies for kidney stone disease with focus on study outcome, type, population, time trends, and patient centered approaches.
A systematic scoping review was performed for articles published between January 1, 2005, and March 30, 2021, using keywords relevant to kidney stone disease. Studies published in English that compared two or more alternative methods for prevention, diagnosis, treatment, monitoring, or care delivery were included. Two reviewers independently reviewed abstracts and an arbitrator resolved discrepancies. Nine reviewers abstracted information from full-length studies. Descriptive statistics were summarized, and linear regression was performed to evaluate temporal trends of study characteristics.
We reviewed 1773 abstracts and 707 full-length manuscripts focused on surgical intervention (440); medical expulsive therapy (MET) (152); analgesic control (80); and homeopathic, diagnostics, and/or prophylaxis (84). Randomized controlled trials were common across all outcome categories, including surgery (41.6%), MET (60.2%), analgesic control (81.3%), homeopathic (41.2%), diagnostic (47.6%), and prophylaxis (49.1%). Patient reported outcomes (PRO) were utilized in 71.7% and 95% of MET and analgesic control studies, respectively, but in the minority of all other study themes. Over time, meta-analyses and multi-center studies increased [P < 0.001].
Surgical and MET themes dominate published comparative literature in kidney stone disease. There is substantial variation in use of PROs across surgical themes. Multi-centered studies and those generating higher level evidence have increased over time but opportunities exist to improve collaborative, high-quality, and patient-centered research in kidney stone disease.
Urology. 2023 Oct 05 [Epub ahead of print]
Pankaj Dangle, Gregory E Tasian, David I Chu, Rachel Shannon, Ryan Spiardi, Alice H Xiang, Aditya Jadcherla, Juliana Arenas, Jonathan S Ellison
Division of Pediatric Urology, Riley Hopsital for Children at IU Health, Indianapolis, IN; Department of Surgery, Division of Urology, The Children's Hospital of Philadelphia, Philadelphia, PA., Department of Surgery, Division of Urology, The Children's Hospital of Philadelphia, Philadelphia, PA; Department of Biostatistics, Epidemiology, and Informatics; Perelman School of Medicine at the University of Pennsylvania, Philadelphia, PA; Department of Surgery, Division of Urology, The Children's Hospital of Philadelphia, Philadelphia, PA., Division of Urology, Ann & Robert H Lurie Children's Hospital of Chicago, Chicago, IL; Department of Surgery, Division of Urology, The Children's Hospital of Philadelphia, Philadelphia, PA., Renal-Electrolyte & Hypertension Division, Department of Medicine, University of Pennsylvania, Philadelphia, PA; Department of Surgery, Division of Urology, The Children's Hospital of Philadelphia, Philadelphia, PA., Department of Surgery, Division of Urology, The Children's Hospital of Philadelphia, Philadelphia, PA; Department of Surgery, Division of Urology, The Children's Hospital of Philadelphia, Philadelphia, PA., Division of Pediatric Urology & Department of Urology, Children's Wisconsin and Medical College of Wisconsin, Milwaukee WI; Department of Surgery, Division of Urology, The Children's Hospital of Philadelphia, Philadelphia, PA., Pontifical Xavierian University, Bogota, Colombia; Department of Surgery, Division of Urology, The Children's Hospital of Philadelphia, Philadelphia, PA., Division of Pediatric Urology & Department of Urology, Children's Wisconsin and Medical College of Wisconsin, Milwaukee WI; Department of Surgery, Division of Urology, The Children's Hospital of Philadelphia, Philadelphia, PA. Electronic address: .