Latenstein et al reported a clinical decision tool for predicting significant pain relief following cholecystectomy in a patient with symptomatic cholelithiasis. The authors are from multiple insitutions in The Netherlands.
Patient selection: symptomatic cholecystitis
Parameters:
(1) age in years
(2) history of abdominal surgery
(3) VAS pain score at baseline (from 0 to 10)
(4) pain radiating to the back
(5) positive response to simple analgesics
(6) nausea during pain attacks
(7) heartburn
Parameter
Finding
Points
age in years
0.01 * (age)
history of abdominal surgery
no
0
yes
-0.57
VAS pain score
0.57 * (VAS score)
pain radiating to back
no
0
yes
0.62
positive response to simple analgesics
no
0
yes
0.47
did not use
1.21
nausea during attack
no
0
yes
0.48
heartburn
no
0
yes
-0.79
value of X =
= SUM(points for all of the parameters) - 5.03
probability of significant pain reduction after cholecystectomy =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.80 in the derivation set and 0.74 in the external validation set.
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