scholarly journals Prediction of vaginal birth after cesarean delivery in southeast China: A retrospective cohort study

2020 ◽  
Author(s):  
Hua-Le Zhang ◽  
Liang-Hui Zheng ◽  
Li-Chun Cheng ◽  
Zhao-Dong Liu ◽  
Lu Yu ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Success Rate ◽  
Gestational Age ◽  
Curve Analysis ◽  
Inclusion Criteria ◽  
Vaginal Birth After Cesarean ◽  
Training Set ◽  
Decision Curve Analysis ◽  
Validation Set

Abstract Objective To develop and validate a nomogram to better predict the vaginal birth after cesarean (VBAC) on the premise of clinical guide application. Methods We retrospectively identified hospitalised pregnant women who trial of labor after cesarean (TOLAC) between October 2015 and October 2017 using data from the Fujian Provincial Maternity and Children's Hospital. The inclusion criteria were as follows: Singleton pregnant women whose gestational age was above 37 weeks and underwent a primary cesarean section. Sociodemographic data and Clinical Characteristics were extracted. The samples were randomly divided into a training set and a validation set. Least absolute shrinkage and selection operator (LASSO) regression were used to select variables and construct of VBAC success rate in training set. The validation of the nomogram was performed using the concordance index (C-index), decision curve analysis (DCA), and calibration curves in the validation set. For comparison with published VBAC prediction models, the Grobman’s model was used. Results Among the 708 pregnant women included according to inclusion criteria, 586 (82.77%) patients were successfully for VBAC. In multivariate logistic regression models, Maternal height (OR, 1.11; 95% CI, 1.04 to 1.19), maternal BMI at delivery (OR, 0.89; 95% CI, 0.79 to 1.00), fundal height (OR, 0.71; 95% CI, 0.58 to 0.88), cervix Bishop score (OR, 3.27; 95% CI, 2.49 to 4.45), maternal age at delivery (OR, 0.90; 95% CI, 0.82 to 0.98), gestational age (OR, 0.33; 95% CI, 0.17 to 0.62) and history of vaginal delivery (OR, 2.92; 95% CI, 1.42 to 6.48) were independently associated with successful VBAC. The predictive model was constructed showed better discrimination in the validation series than Grobman’s model (c-index 0.906 VS 0.694, respectively). Decision curve analysis revealed that the new model resulted in a better clinical net benefit than the Grobman’s model. Conclusions The promotion of VBAC is helpful to reduce the cesarean section rate in China. On the basis of following the clinical practice guidelines, the TOLAC prediction model helps to improve the success rate of VBAC and has a potential contribution to the reduction of secondary cesarean section.

scholarly journals Prediction of vaginal birth after cesarean delivery in Southeast China: a retrospective cohort study

2020 ◽  
Vol 20 (1) ◽  
Author(s):  
Hua-Le Zhang ◽  
Liang-Hui Zheng ◽  
Li-Chun Cheng ◽  
Zhao-Dong Liu ◽  
Lu Yu ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Success Rate ◽  
Gestational Age ◽  
Prediction Models ◽  
Curve Analysis ◽  
Vaginal Birth ◽  
Lasso Regression ◽  
Vaginal Birth After Cesarean ◽  
Decision Curve Analysis

Abstract Background We aimed to develop and validate a nomogram for effective prediction of vaginal birth after cesarean (VBAC) and guide future clinical application. Methods We retrospectively analyzed data from hospitalized pregnant women who underwent trial of labor after cesarean (TOLAC), at the Fujian Provincial Maternity and Children’s Hospital, between October 2015 and October 2017. Briefly, we included singleton pregnant women, at a gestational age above 37 weeks who underwent a primary cesarean section, in the study. We then extracted their sociodemographic data and clinical characteristics, and randomly divided the samples into training and validation sets. We employed the least absolute shrinkage and selection operator (LASSO) regression to select variables and construct VBAC success rate in the training set. Thereafter, we validated the nomogram using the concordance index (C-index), decision curve analysis (DCA), and calibration curves. Finally, we adopted the Grobman’s model to perform comparisons with published VBAC prediction models. Results Among the 708 pregnant women included according to inclusion criteria, 586 (82.77%) patients were successfully for VBAC. Multivariate logistic regression models revealed that maternal height (OR, 1.11; 95% CI, 1.04 to 1.19), maternal BMI at delivery (OR, 0.89; 95% CI, 0.79 to 1.00), fundal height (OR, 0.71; 95% CI, 0.58 to 0.88), cervix Bishop score (OR, 3.27; 95% CI, 2.49 to 4.45), maternal age at delivery (OR, 0.90; 95% CI, 0.82 to 0.98), gestational age (OR, 0.33; 95% CI, 0.17 to 0.62) and history of vaginal delivery (OR, 2.92; 95% CI, 1.42 to 6.48) were independently associated with successful VBAC. The constructed predictive model showed better discrimination than that from the Grobman’s model in the validation series (c-index 0.906 VS 0.694, respectively). On the other hand, decision curve analysis revealed that the new model had better clinical net benefits than the Grobman’s model. Conclusions VBAC will aid in reducing the rate of cesarean sections in China. In clinical practice, the TOLAC prediction model will help improve VBAC’s success rate, owing to its contribution to reducing secondary cesarean section.

scholarly journals Prediction of vaginal birth after cesarean delivery in southeast China: A retrospective cohort study

2020 ◽  
Author(s):  
Hua-Le Zhang ◽  
Liang-Hui Zheng ◽  
Li-Chun Cheng ◽  
Zhao-Dong Liu ◽  
Lu Yu ◽  
...  
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Success Rate ◽  
Gestational Age ◽  
Prediction Models ◽  
Curve Analysis ◽  
Vaginal Birth ◽  
Lasso Regression ◽  
Vaginal Birth After Cesarean ◽  
Decision Curve Analysis

Abstract Background We aimed to develop and validate a nomogram for effective prediction of vaginal birth after cesarean (VBAC) and guide future clinical application. Methods We retrospectively analyzed data from hospitalized pregnant women who underwent trial of labor after cesarean (TOLAC), at the Fujian Provincial Maternity and Children's Hospital, between October 2015 and October 2017. Briefly, we included singleton pregnant women, at a gestational age above 37 weeks who underwent a primary cesarean section, in the study. We then extracted their sociodemographic data and clinical characteristics, and randomly divided the samples into training and validation sets. We employed the least absolute shrinkage and selection operator (LASSO) regression to select variables and construct VBAC success rate in the training set. Thereafter, we validated the nomogram using the concordance index (C-index), decision curve analysis (DCA), and calibration curves. Finally, we adopted the Grobman’s model to perform comparisons with published VBAC prediction models. Results Among the 708 pregnant women included according to inclusion criteria, 586 (82.77%) patients were successfully for VBAC. Multivariate logistic regression models revealed that maternal height (OR, 1.11; 95% CI, 1.04 to 1.19), maternal BMI at delivery (OR, 0.89; 95% CI, 0.79 to 1.00), fundal height (OR, 0.71; 95% CI, 0.58 to 0.88), cervix Bishop score (OR, 3.27; 95% CI, 2.49 to 4.45), maternal age at delivery (OR, 0.90; 95% CI, 0.82 to 0.98), gestational age (OR, 0.33; 95% CI, 0.17 to 0.62) and history of vaginal delivery (OR, 2.92; 95% CI, 1.42 to 6.48) were independently associated with successful VBAC. The constructed predictive model showed better discrimination than that from the Grobman’s model in the validation series (c-index 0.906 VS 0.694, respectively). On the other hand, decision curve analysis revealed that the new model had better clinical net benefits than the Grobman’s model. Conclusions VBAC will aid in reducing the rate of cesarean sections in China. In clinical practice, the TOLAC prediction model will help improve VBAC’s success rate, owing to its contribution to reducing secondary cesarean section.

scholarly journals Establishment and Validation of a Clinically Predictive Nomogram Model for Thyroid Carcinoma Patients

2020 ◽  
Author(s):  
Ruyi Zhang ◽  
Mei Xu ◽  
Xiangxiang Liu ◽  
Miao Wang ◽  
Qiang Jia ◽  
...  
Keyword(s):  
Thyroid Carcinoma ◽  
External Validation ◽  
Cancer Staging ◽  
Curve Analysis ◽  
Calibration Plot ◽  
Net Benefit ◽  
Training Set ◽  
Decision Curve Analysis ◽  
Validation Set ◽  
Good Calibration

Abstract Objectives To develop a clinically predictive nomogram model which can maximize patients’ net benefit in terms of predicting the prognosis of patients with thyroid carcinoma based on the 8th edition of the AJCC Cancer Staging method. MethodsWe selected 134,962 thyroid carcinoma patients diagnosed between 2004 and 2015 from SEER database with details of the 8th edition of the AJCC Cancer Staging Manual and separated those patients into two datasets randomly. The first dataset, training set, was used to build the nomogram model accounting for 80% (94,474 cases) and the second dataset, validation set, was used for external validation accounting for 20% (40,488 cases). Then we evaluated its clinical availability by analyzing DCA (Decision Curve Analysis) performance and evaluated its accuracy by calculating AUC, C-index as well as calibration plot.ResultsDecision curve analysis showed the final prediction model could maximize patients’ net benefit. In training set and validation set, Harrell’s Concordance Indexes were 0.9450 and 0.9421 respectively. Both sensitivity and specificity of three predicted time points (12 Months,36 Months and 60 Months) of two datasets were all above 0.80 except sensitivity of 60-month time point of validation set was 0.7662. AUCs of three predicted timepoints were 0.9562, 0.9273 and 0.9009 respectively for training set. Similarly, those numbers were 0.9645, 0.9329, and 0.8894 respectively for validation set. Calibration plot also showed that the nomogram model had a good calibration.ConclusionThe final nomogram model provided with both excellent accuracy and clinical availability and should be able to predict patients’ survival probability visually and accurately.

scholarly journals MRI-Based Radiomics Nomogram To Predict Intraoperative Hemorrhage of Placenta Previa

2021 ◽  
Author(s):  
Ye Song ◽  
Liping Zhu ◽  
Dali Chen ◽  
Yongmei Li ◽  
Qi Xi ◽  
...  
Keyword(s):  
Predictive Accuracy ◽  
Placenta Previa ◽  
Preoperative Evaluation ◽  
Curve Analysis ◽  
Training Set ◽  
Decision Curve Analysis ◽  
Preoperative Prediction ◽  
Mri Features ◽  
Wide Range ◽  
Validation Set

Abstract Background: Placenta previa is associated with higher percentage of intraoperative and postpartum hemorrhage, increased obstetric hysterectomy, significant maternal morbidity and mortality. We aimed to develop and validate a magnetic resonance imaging (MRI)-based nomogram to preoperative prediction of intraoperative hemorrhage (IPH) for placenta previa, which might contribute to adequate assessment and preoperative preparation for the obstetricians.Methods: Between May 2015 and December 2019, a total of 125 placenta previa pregnant women were divided into a training set (n = 80) and a validation set (n = 45). Radiomics features were extracted from MRI images of each patient. A MRI-based model comprising seven features was built for the classification of patients into IPH and non-IPH groups in a training set and validation set. Multivariate nomograms based on logistic regression analyses were built according to radiomics features. Receiver operating characteristic (ROC) curve was used to assess the model. Predictive accuracy of nomogram were assessed by calibration plots and decision curve analysis. Results: In multivariate analysis, placenta position, placenta thickness, cervical blood sinus and placental signals in the cervix were signifcantly independent predictors for IPH (all p < 0.05). The MRI-based nomogram showed favorable discrimination between IPH and non-IPH groups. The calibration curve showed good agreement between the estimated and the actual probability of IPH. Decision curve analysis also showed a high clinical benefit across a wide range of probability thresholds. The AUC was 0.918 ( 95% CI, 0.857-0.979 ) in the training set and 0.866( 95% CI, 0.748-0.985 ) in the validation set by the combination of four MRI features.Conclusions: The MRI-based nomograms might be a useful tool for the preoperative prediction of IPH outcomes for placenta previa. Our study enables obstetricians to perform adequate preoperative evaluation to minimize blood loss and reduce the rate of caesarean hysterectomy.

scholarly journals Clinical and CT Radiomics Nomogram for Preoperative Differentiation of Pulmonary Adenocarcinoma From Tuberculoma in Solitary Solid Nodule

2021 ◽  
Vol 11 ◽  
Author(s):  
Yaoyao Zhuo ◽  
Yi Zhan ◽  
Zhiyong Zhang ◽  
Fei Shan ◽  
Jie Shen ◽  
...  
Keyword(s):  
Clinical Features ◽  
Ct Images ◽  
Curve Analysis ◽  
Good Prediction ◽  
Training Set ◽  
Minimum Diameter ◽  
Decision Curve Analysis ◽  
Thin Slice ◽  
Solid Nodule ◽  
Validation Set

AimTo investigate clinical and computed tomography (CT) radiomics nomogram for preoperative differentiation of lung adenocarcinoma (LAC) from lung tuberculoma (LTB) in patients with pulmonary solitary solid nodule (PSSN).Materials and MethodsA total of 313 patients were recruited in this retrospective study, including 96 pathologically confirmed LAC and 217 clinically confirmed LTB. Patients were assigned at random to training set (n = 220) and validation set (n = 93) according to 7:3 ratio. A total of 2,589 radiomics features were extracted from each three-dimensional (3D) lung nodule on thin-slice CT images and radiomics signatures were built using the least absolute shrinkage and selection operator (LASSO) logistic regression. The predictive nomogram was established based on radiomics and clinical features. Decision curve analysis was performed with training and validation sets to assess the clinical usefulness of the prediction model.ResultsA total of six clinical features were selected as independent predictors, including spiculated sign, vacuole, minimum diameter of nodule, mediastinal lymphadenectasis, sex, and age. The radiomics nomogram of lung nodules, consisting of 15 selected radiomics parameters and six clinical features showed good prediction in the training set [area under the curve (AUC), 1.00; 95% confidence interval (CI), 0.99–1.00] and validation set (AUC, 0.99; 95% CI, 0.98–1.00). The nomogram model that combined radiomics and clinical features was better than both single models (p &lt; 0.05). Decision curve analysis showed that radiomics features were beneficial to clinical settings.ConclusionThe radiomics nomogram, derived from unenhanced thin-slice chest CT images, showed favorable prediction efficacy for differentiating LAC from LTB in patients with PSSN.

15-lncRNAs-based classifier-clinicopathologic nomogram improves the prediction of recurrence in patients with hepatocellular carcinoma

2019 ◽  
Author(s):  
Qiong Zhang ◽  
Gang Ning ◽  
Hongye Jiang ◽  
Yanlin Huang ◽  
Jinsong Piao ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Clinical Decision Making ◽  
Cox Regression ◽  
Curve Analysis ◽  
Tnm Stage ◽  
Training Set ◽  
Decision Curve Analysis ◽  
Clinicopathologic Factors ◽  
Validation Set ◽  
Better Than

Abstract Background: Our study aims to develop an lncRNAs-based classifier and a nomogram incorporating the genomic signature and clinicopathologic factors to help to improve the accuracy of recurrence prediction for hepatocellular carcinoma(HCC) patients.Methods: The lncRNAs profiling data of 374 HCC patients and 50 normal healthy controls were downloaded from the Cancer Genome Atlas (TCGA). Using univariable Cox regression and Least absolute shrinkage and selection operator (LASSO) analysis, we developed 15-lncRNAs-based classifier and compared our classifier to existing six-lncRNAs signature. Besides, a nomogram incorporating the genomic classifier and clinicopathologic factors was also developed. The predictive accuracy and discriminative ability of the genomic-clinicopathologic nomogram were determined by a concordance index (C-index) and calibration curve and were compared with TNM staging system by C-index, receiver operating characteristic (ROC) analysis. Decision curve analysis (DCA) was performed to estimate clinical value of our nomogram.Results: Fifteen relapse-free survival (RFS) -related lncRNAs were identified and the classifer, consisting of the identified15 lncRNAs, could effectively classify patients into high-risk and low-risk subgroup. The prediction accuracy of the 15-lncRNAs-based classifier for predicting 2- year and 5-year RFS were 0.791 and 0.834 in the training set and 0.684 and 0.747 in the validation set, which was better than the existing six-lncRNAs signature. Moreover, the AUC of genomic-clinicopathologic nomogram in predicting RFS were 0.837 in the training set and 0.753 in the validation set, and the C-index of the genomic-clinicopathologic nomogram was 0.78 (0.72-0.83) in the training set and 0.71 (0.65-0.76) in the validation set, which was better than traditional TNM stage and 15-lncRNAs-based classifier. Decision curve analysis further demonstrated that our nomogram had larger net benefit than TNM stage and 15-lncRNAs-based classifier. Conclusion: Compared to TNM stage, the 15-lncRNAs-based classifier-clinicopathologic nomogram is a more effective and valuable tool to identify HCC recurrence and may aid in clinical decision-making.

scholarly journals 15-lncRNA-Based Classifier-Clinicopathologic Nomogram Improves the Prediction of Recurrence in Patients with Hepatocellular Carcinoma

2020 ◽  
Vol 2020 ◽  
pp. 1-15
Author(s):  
Qiong Zhang ◽  
Gang Ning ◽  
Hongye Jiang ◽  
Yanlin Huang ◽  
Jinsong Piao ◽  
...  
Keyword(s):  
Hepatocellular Carcinoma ◽  
Clinical Decision Making ◽  
Cox Regression ◽  
Curve Analysis ◽  
Tnm Stage ◽  
Training Set ◽  
Decision Curve Analysis ◽  
Clinicopathologic Factors ◽  
Validation Set ◽  
Better Than

Background. Our study aims to develop a lncRNA-based classifier and a nomogram incorporating the genomic signature and clinicopathologic factors to help to improve the accuracy of recurrence prediction for hepatocellular carcinoma (HCC) patients. Methods. The lncRNA profiling data of 374 HCC patients and 50 normal healthy controls were downloaded from The Cancer Genome Atlas (TCGA). Using univariable Cox regression and least absolute shrinkage and selection operator (LASSO) analysis, we developed a 15-lncRNA-based classifier and compared our classifier to the existing six-lncRNA signature. Besides, a nomogram incorporating the genomic classifier and clinicopathologic factors was also developed. The predictive accuracy and discriminative ability of the genomic-clinicopathologic nomogram were determined by a concordance index (C-index) and calibration curve and were compared with the TNM staging system by the C-index and receiver operating characteristic (ROC) analysis. Decision curve analysis (DCA) was performed to estimate the clinical value of our nomogram. Results. Fifteen relapse-free survival (RFS-) related lncRNAs were identified, and the classifier, consisting of the identified 15 lncRNAs, could effectively classify patients into the high-risk and low-risk subgroups. The prediction accuracy of the 15-lncRNA-based classifier for predicting 2-year and 5-year RFS was 0.791 and 0.834 in the training set and 0.684 and 0.747 in the validation set, respectively, which was better than the existing six-lncRNA signature. Moreover, the AUC of genomic-clinicopathologic nomogram in predicting RFS were 0.837 in the training set and 0.753 in the validation set, and the C-index of the genomic-clinicopathologic nomogram was 0.78 (0.72-0.83) in the training set and 0.71 (0.65-0.76) in the validation set, which was better than the traditional TNM stage and 15-lncRNA-based classifier. The decision curve analysis further demonstrated that our nomogram had a larger net benefit than the TNM stage and 15-lncRNA-based classifier. The results were confirmed externally. Conclusion. Compared to the TNM stage, the 15-lncRNAs-based classifier-clinicopathologic nomogram is a more effective and valuable tool to identify HCC recurrence and may aid in clinical decision-making.

scholarly journals Prognostic Nomograms for Primary High-Grade Glioma Patients in Adult: A Retrospective Study Based on the SEER Database

2020 ◽  
Vol 2020 ◽  
pp. 1-19
Author(s):  
Yi Yang ◽  
Mingze Yao ◽  
Shengrong Long ◽  
Chengran Xu ◽  
Lun Li ◽  
...  
Keyword(s):  
High Grade Glioma ◽  
Curve Analysis ◽  
Histological Type ◽  
High Grade ◽  
Seer Database ◽  
Operating Characteristics ◽  
Training Set ◽  
Decision Curve Analysis ◽  
Validation Set ◽  
Cox Analysis

Purpose. In our study, we aimed to screen the risk factors that affect overall survival (OS) and cancer-specific survival (CSS) in adult glioma patients and to develop and evaluate nomograms. Methods. Primary high-grade gliomas patients being retrieved from the surveillance, epidemiology and end results (SEER) database, between 2004 and 2015, then they randomly assigned to a training group and a validation group. Univariate and multivariate Cox analysis models were used to choose the variables significantly correlated with the prognosis of high-grade glioma patients. And these variables were used to construct the nomograms. Next, concordance index (C-index), calibration plot and receiver operating characteristics (ROCs) curve were used to evaluate the accuracy of the nomogram model. In addition, the decision curve analysis (DCA) was used to analyze the benefit of nomogram and prognostic indicators commonly used in clinical practice. Results. A total of 6395 confirmed glioma patients were selected from the SEER database, divided into training set (n =3166) and validation set (n =3229). Age at diagnosis, tumor grade, tumor size, histological type, surgical type, radiotherapy and chemotherapy were screened out by Cox analysis model. For OS nomogram, the C-index of the training set was 0.741 (95% CI: 0.751-0.731), and the validation set was 0.738 (95% CI: 0.748-0.728). For CSS nomogram, the C-index of the training set was 0.739 (95% CI: 0.749-0.729), and the validation set was 0.738 (95% CI: 0.748-0.728). The net benefit and net reduction in inverventions of nomograms in the decision curve analysis (DCA) was higher than histological type. Conclusions. We developed nomograms to predict 3- and 5-year OS rates and 3- and 5-year CSS rates in adult high-grade glioma patients. Both the training set and the validation set showed good calibration and validation, indicating the clinical applicability of the nomogram and good predictive results.

scholarly journals Frequency of Successful Vaginal Birth after Previous One Cesarean Section in Low Risk Pregnant Women

2016 ◽  
Vol 22 (1) ◽  
pp. 60
Author(s):  
Saadia Rasheed ◽  
Sehar Shahbaz ◽  
Shazia Hammad
Keyword(s):  
Cesarean Section ◽  
Pregnant Women ◽  
Success Rate ◽  
Placental Abruption ◽  
Cost Effective ◽  
Vaginal Birth ◽  
Low Risk ◽  
Vaginal Birth After Cesarean ◽  
Live Fetus ◽  
Prior Cesarean Section

AbstractAims and Objectives:determine the frequency of successful vaginal birth after cesarean section VBAC in low risk pregnant women.Study Design: It was a descriptive study.Duration:From 2010 to 2014.Material and Method:A total of 130 cases who were at term (37)+ weeks of gestation, between 20 40 years of age with a single prior cesarean section, presenting in their next pregnancy (G2) with a single, live fetus in cephalic presentation and those who given the consent of trial of VBAC were included in the study while high risk cases e.g. hypertensive disorders, gestational diabetes mellitus, placental abruption etc were excluded from this review. All these cases were collected from Maternity and Children's hospital Hail, Kingdom of Saudia Arabia.Results:In our study, 63.85% of the cases were between 20 30 years of age while 36.15% (n = 47) were between 31 40 years, mean sd was calculated as 27.24 3.52 years, mean gestational age was 38.43 2.43 weeks while successful vaginal birth after cesarean section was recorded in 78.46% (n = 102) while 21.54% (n = 28) had failed trial of VBAC.Conclusion:Higher success rate of vaginal birth after one cesarean section in low risk pregnant women is recorded while no significant adverse outcome in these cases is found. However, in our setup it is safe and cost-effective as well.Key Words:Cesarean delivery, low risk, VBAC, success rate, safe, cost effective.

scholarly journals Scoring system development and validation for prediction choledocholithiasis before open cholecystectomy

2015 ◽  
Vol 143 (11-12) ◽  
pp. 681-687 ◽  
Author(s):  
Tomislav Pejovic ◽  
Miroslav Stojadinovic
Keyword(s):  
Bile Duct ◽  
Clinical Utility ◽  
Clinical Decision Making ◽  
Prediction Models ◽  
Open Cholecystectomy ◽  
Univariate Analysis ◽  
Curve Analysis ◽  
Decision Curve Analysis ◽  
Scoring Model ◽  
Validation Set

Introduction. Accurate precholecystectomy detection of concurrent asymptomatic common bile duct stones (CBDS) is key in the clinical decision-making process. The standard preoperative methods used to diagnose these patients are often not accurate enough. Objective. The aim of the study was to develop a scoring model that would predict CBDS before open cholecystectomy. Methods. We retrospectively collected preoperative (demographic, biochemical, ultrasonographic) and intraoperative (intraoperative cholangiography) data for 313 patients at the department of General Surgery at Gornji Milanovac from 2004 to 2007. The patients were divided into a derivation (213) and a validation set (100). Univariate and multivariate regression analysis was used to determine independent predictors of CBDS. These predictors were used to develop scoring model. Various measures for the assessment of risk prediction models were determined, such as predictive ability, accuracy, the area under the receiver operating characteristic curve (AUC), calibration and clinical utility using decision curve analysis. Results. In a univariate analysis, seven risk factors displayed significant correlation with CBDS. Total bilirubin, alkaline phosphatase and bile duct dilation were identified as independent predictors of choledocholithiasis. The resultant total possible score in the derivation set ranged from 7.6 to 27.9. Scoring model shows good discriminatory ability in the derivation and validation set (AUC 94.3 and 89.9%, respectively), excellent accuracy (95.5%), satisfactory calibration in the derivation set, similar Brier scores and clinical utility in decision curve analysis. Conclusion. Developed scoring model might successfully estimate the presence of choledocholithiasis in patients planned for elective open cholecystectomy.

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