Comparing CHOKAI and STONE Scores in Predicting Ureteral Stones in The Emergency Department: A Prospective Multicenter Diagnostic Study

Background: The CHOKAI and STONE scores were developed to predict ureteral stones as a cause of renal colic. Objectives: We aimed to compare the diagnostic accuracy of both scores in predicting the presence of ureteral stones in suspected acute renal colic in the United Arab Emirates. Methods: This prospective multicenter diagnostic study included patients greater than 16 years old with suspected renal colic in the Emergency Department (ED) from 2021 to 2022, evaluating parameters that form the CHOKAI and STONE scores. Patients were divided into 2 groups: those with ureteral stones and those without stones as determined by a non-contrast computed tomography (CT) scan report. A Receiver Operator Curve and its coordinates were used to define the area under the curve (AUC) and determine the optimal cut-off point for predicting ureteral stones for the 2 scores. Results: Of 92 patients included in the study, 70 (76%) had ureteral stones. AUC of the CHOKAI score was 0.85 (95% Confidence Interval (CI) 0.73–0.95). The best cut-off point of the CHOKAI was 7, with a sensitivity of 0.87, specificity of 0.73, positive liklihood ratio (LR) of 3.19, and negative LR of 0.178. AUC of the STONE score was 0.8 (95% CI 0.70–0.91). The best cut-off point of the STONE score was 5, with a sensitivity of 0.83, specificity of 0.64, positive LR of 2.78, and negative LR of 0.27. Conclusions: In our population, the CHOKAI score was a better predictor of the presence of ureteral stones than the STONE score in the ED.