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13 Our data show that the quantitative effects of the five factors incorporated into the STONE score can accurately predict ureteral stone and allow stratification of patients in the emergency department with suspected kidney stone into one of three groups: low probability (≤10% chance of stone), moderate probability (about 50% chance of stone), and high probability (about 90% chance of stone).
When a clinician orders a CT for kidney stone the questions asked and a STONE score with risk category accompanies the radiology order.
Additionally, we found that the likelihood of an acutely important alternative finding is inversely proportional to the probability of a ureteral stone being present, as predicted by the STONE score.
In terms of potential clinical utility, if a CT scan is being considered for suspected kidney stone and a patient has a high STONE score (which occurred in about a third of patients: 30.6% in the derivation cohort and 37.7% in the validation cohort), then the patient is very likely to have a kidney stone and very unlikely to have an important non-kidney stone cause of symptoms.
Conclusions The STONE score reliably predicts the presence of uncomplicated ureteral stone and lower likelihood of acutely important alternative findings.
We did find the presence of hydronephrosis on CT to be highly predictive of ureteral stone, and future work will incorporate the presence of hydronephrosis on ultrasonography into the STONE score.
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