The surgeon’s role on chemical investigations of the composition of urinary stones

Abstract The chemical analysis of an urolith is often interpreted as “stone’s composition”. However, it must be taken into consideration, that in most cases, only a fragment of the stone has been sent to the laboratory. In some recurrent patients, stone compositions either vary considerably between episodes or the analytical result obtained from the stone fragment does not fit with the data of e.g. current 24 h-urinalysis or urinary pH-records. The question arises, whether this outcome may be the result of an improper stone sampling scheme. On a simple layered 2D-stone model composed of two mineral phases it is shown, how the choice of a stone fragment process may influence the result of “stone composition”. Depending on the initial position of fragment within the whole stone, the respective calculated analyses can relevantly differ from the whole stone composition as well as strongly between two fragments. Even under the simplified conditions of a 2D-2-component-model “grown” under defined conditions, the differences between the analyses of the different specimens taken from a stone are in part remarkable. The more it can be argued that these differences increase if a real 3D-urolith is investigated. Further sampling biases may evolve and increase the problem of proper sampling:, e.g., if an urolith’s more resistant parts remain intact while ESWL or laser-based stone fragmentation (“dusting”), the weak parts became fully disintegrated and removed from the body as fine-grained sludge—the stone’s fine fraction is lost although its composition may carry important information on the stone’s pathogenesis. Consequently, a “stone analysis” only obtained from the harder remains reveals an incomplete result, a fact that in principle limits its clinical interpretation. Choice of stone fragment is crucial. The extent of the uncertainty of an analysis resulting from potential selection biases should not be underestimated. Thus, sampling should be considered as an important part of the processes of quality assurance and management. Errors made at this early stage of diagnosis finding will affect the analytical result and thus influence the clarification of the underlying pathomechanism. This can lead to an improper metaphylactic strategy potentially causing recurrent stone formation which otherwise would have been prevented. A decision scheme for analysis of urinary stones removed using endoscopic methods is suggested. Ausführliche Beschreibung

Gespeichert in:

Autor*in:	Laube, Norbert [verfasserIn] Klein, Florian [verfasserIn] Fisang, Christian [verfasserIn]

Format:	E-Artikel
Sprache:	Englisch

Erschienen:	2020

Schlagwörter:	Sampling strategy Sampling bias Representative sampling Analysis based therapy

Übergeordnetes Werk:	Enthalten in: Urological research - Berlin : Springer, 1973, 48(2020), 5 vom: 20. Mai, Seite 435-441
Übergeordnetes Werk:	volume:48 ; year:2020 ; number:5 ; day:20 ; month:05 ; pages:435-441

Links:	Volltext

DOI / URN:	10.1007/s00240-020-01195-6

Katalog-ID:	SPR040928241

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allfields	10.1007/s00240-020-01195-6 doi (DE-627)SPR040928241 (SPR)s00240-020-01195-6-e DE-627 ger DE-627 rakwb eng 610 ASE 44.88 bkl Laube, Norbert verfasserin aut The surgeon’s role on chemical investigations of the composition of urinary stones 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract The chemical analysis of an urolith is often interpreted as “stone’s composition”. However, it must be taken into consideration, that in most cases, only a fragment of the stone has been sent to the laboratory. In some recurrent patients, stone compositions either vary considerably between episodes or the analytical result obtained from the stone fragment does not fit with the data of e.g. current 24 h-urinalysis or urinary pH-records. The question arises, whether this outcome may be the result of an improper stone sampling scheme. On a simple layered 2D-stone model composed of two mineral phases it is shown, how the choice of a stone fragment process may influence the result of “stone composition”. Depending on the initial position of fragment within the whole stone, the respective calculated analyses can relevantly differ from the whole stone composition as well as strongly between two fragments. Even under the simplified conditions of a 2D-2-component-model “grown” under defined conditions, the differences between the analyses of the different specimens taken from a stone are in part remarkable. The more it can be argued that these differences increase if a real 3D-urolith is investigated. Further sampling biases may evolve and increase the problem of proper sampling:, e.g., if an urolith’s more resistant parts remain intact while ESWL or laser-based stone fragmentation (“dusting”), the weak parts became fully disintegrated and removed from the body as fine-grained sludge—the stone’s fine fraction is lost although its composition may carry important information on the stone’s pathogenesis. Consequently, a “stone analysis” only obtained from the harder remains reveals an incomplete result, a fact that in principle limits its clinical interpretation. Choice of stone fragment is crucial. The extent of the uncertainty of an analysis resulting from potential selection biases should not be underestimated. Thus, sampling should be considered as an important part of the processes of quality assurance and management. Errors made at this early stage of diagnosis finding will affect the analytical result and thus influence the clarification of the underlying pathomechanism. This can lead to an improper metaphylactic strategy potentially causing recurrent stone formation which otherwise would have been prevented. A decision scheme for analysis of urinary stones removed using endoscopic methods is suggested. Sampling strategy (dpeaa)DE-He213 Sampling bias (dpeaa)DE-He213 Representative sampling (dpeaa)DE-He213 Analysis based therapy (dpeaa)DE-He213 Klein, Florian verfasserin aut Fisang, Christian verfasserin aut Enthalten in Urological research Berlin : Springer, 1973 48(2020), 5 vom: 20. Mai, Seite 435-441 (DE-627)254236901 (DE-600)1461962-3 1434-0879 nnns volume:48 year:2020 number:5 day:20 month:05 pages:435-441 https://dx.doi.org/10.1007/s00240-020-01195-6 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_152 GBV_ILN_161 GBV_ILN_171 GBV_ILN_187 GBV_ILN_224 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2057 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2119 GBV_ILN_2129 44.88 ASE AR 48 2020 5 20 05 435-441
spelling	10.1007/s00240-020-01195-6 doi (DE-627)SPR040928241 (SPR)s00240-020-01195-6-e DE-627 ger DE-627 rakwb eng 610 ASE 44.88 bkl Laube, Norbert verfasserin aut The surgeon’s role on chemical investigations of the composition of urinary stones 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract The chemical analysis of an urolith is often interpreted as “stone’s composition”. However, it must be taken into consideration, that in most cases, only a fragment of the stone has been sent to the laboratory. In some recurrent patients, stone compositions either vary considerably between episodes or the analytical result obtained from the stone fragment does not fit with the data of e.g. current 24 h-urinalysis or urinary pH-records. The question arises, whether this outcome may be the result of an improper stone sampling scheme. On a simple layered 2D-stone model composed of two mineral phases it is shown, how the choice of a stone fragment process may influence the result of “stone composition”. Depending on the initial position of fragment within the whole stone, the respective calculated analyses can relevantly differ from the whole stone composition as well as strongly between two fragments. Even under the simplified conditions of a 2D-2-component-model “grown” under defined conditions, the differences between the analyses of the different specimens taken from a stone are in part remarkable. The more it can be argued that these differences increase if a real 3D-urolith is investigated. Further sampling biases may evolve and increase the problem of proper sampling:, e.g., if an urolith’s more resistant parts remain intact while ESWL or laser-based stone fragmentation (“dusting”), the weak parts became fully disintegrated and removed from the body as fine-grained sludge—the stone’s fine fraction is lost although its composition may carry important information on the stone’s pathogenesis. Consequently, a “stone analysis” only obtained from the harder remains reveals an incomplete result, a fact that in principle limits its clinical interpretation. Choice of stone fragment is crucial. The extent of the uncertainty of an analysis resulting from potential selection biases should not be underestimated. Thus, sampling should be considered as an important part of the processes of quality assurance and management. Errors made at this early stage of diagnosis finding will affect the analytical result and thus influence the clarification of the underlying pathomechanism. This can lead to an improper metaphylactic strategy potentially causing recurrent stone formation which otherwise would have been prevented. A decision scheme for analysis of urinary stones removed using endoscopic methods is suggested. Sampling strategy (dpeaa)DE-He213 Sampling bias (dpeaa)DE-He213 Representative sampling (dpeaa)DE-He213 Analysis based therapy (dpeaa)DE-He213 Klein, Florian verfasserin aut Fisang, Christian verfasserin aut Enthalten in Urological research Berlin : Springer, 1973 48(2020), 5 vom: 20. Mai, Seite 435-441 (DE-627)254236901 (DE-600)1461962-3 1434-0879 nnns volume:48 year:2020 number:5 day:20 month:05 pages:435-441 https://dx.doi.org/10.1007/s00240-020-01195-6 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_152 GBV_ILN_161 GBV_ILN_171 GBV_ILN_187 GBV_ILN_224 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2057 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2119 GBV_ILN_2129 44.88 ASE AR 48 2020 5 20 05 435-441
allfields_unstemmed	10.1007/s00240-020-01195-6 doi (DE-627)SPR040928241 (SPR)s00240-020-01195-6-e DE-627 ger DE-627 rakwb eng 610 ASE 44.88 bkl Laube, Norbert verfasserin aut The surgeon’s role on chemical investigations of the composition of urinary stones 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract The chemical analysis of an urolith is often interpreted as “stone’s composition”. However, it must be taken into consideration, that in most cases, only a fragment of the stone has been sent to the laboratory. In some recurrent patients, stone compositions either vary considerably between episodes or the analytical result obtained from the stone fragment does not fit with the data of e.g. current 24 h-urinalysis or urinary pH-records. The question arises, whether this outcome may be the result of an improper stone sampling scheme. On a simple layered 2D-stone model composed of two mineral phases it is shown, how the choice of a stone fragment process may influence the result of “stone composition”. Depending on the initial position of fragment within the whole stone, the respective calculated analyses can relevantly differ from the whole stone composition as well as strongly between two fragments. Even under the simplified conditions of a 2D-2-component-model “grown” under defined conditions, the differences between the analyses of the different specimens taken from a stone are in part remarkable. The more it can be argued that these differences increase if a real 3D-urolith is investigated. Further sampling biases may evolve and increase the problem of proper sampling:, e.g., if an urolith’s more resistant parts remain intact while ESWL or laser-based stone fragmentation (“dusting”), the weak parts became fully disintegrated and removed from the body as fine-grained sludge—the stone’s fine fraction is lost although its composition may carry important information on the stone’s pathogenesis. Consequently, a “stone analysis” only obtained from the harder remains reveals an incomplete result, a fact that in principle limits its clinical interpretation. Choice of stone fragment is crucial. The extent of the uncertainty of an analysis resulting from potential selection biases should not be underestimated. Thus, sampling should be considered as an important part of the processes of quality assurance and management. Errors made at this early stage of diagnosis finding will affect the analytical result and thus influence the clarification of the underlying pathomechanism. This can lead to an improper metaphylactic strategy potentially causing recurrent stone formation which otherwise would have been prevented. A decision scheme for analysis of urinary stones removed using endoscopic methods is suggested. Sampling strategy (dpeaa)DE-He213 Sampling bias (dpeaa)DE-He213 Representative sampling (dpeaa)DE-He213 Analysis based therapy (dpeaa)DE-He213 Klein, Florian verfasserin aut Fisang, Christian verfasserin aut Enthalten in Urological research Berlin : Springer, 1973 48(2020), 5 vom: 20. Mai, Seite 435-441 (DE-627)254236901 (DE-600)1461962-3 1434-0879 nnns volume:48 year:2020 number:5 day:20 month:05 pages:435-441 https://dx.doi.org/10.1007/s00240-020-01195-6 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_152 GBV_ILN_161 GBV_ILN_171 GBV_ILN_187 GBV_ILN_224 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2057 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2119 GBV_ILN_2129 44.88 ASE AR 48 2020 5 20 05 435-441
allfieldsGer	10.1007/s00240-020-01195-6 doi (DE-627)SPR040928241 (SPR)s00240-020-01195-6-e DE-627 ger DE-627 rakwb eng 610 ASE 44.88 bkl Laube, Norbert verfasserin aut The surgeon’s role on chemical investigations of the composition of urinary stones 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract The chemical analysis of an urolith is often interpreted as “stone’s composition”. However, it must be taken into consideration, that in most cases, only a fragment of the stone has been sent to the laboratory. In some recurrent patients, stone compositions either vary considerably between episodes or the analytical result obtained from the stone fragment does not fit with the data of e.g. current 24 h-urinalysis or urinary pH-records. The question arises, whether this outcome may be the result of an improper stone sampling scheme. On a simple layered 2D-stone model composed of two mineral phases it is shown, how the choice of a stone fragment process may influence the result of “stone composition”. Depending on the initial position of fragment within the whole stone, the respective calculated analyses can relevantly differ from the whole stone composition as well as strongly between two fragments. Even under the simplified conditions of a 2D-2-component-model “grown” under defined conditions, the differences between the analyses of the different specimens taken from a stone are in part remarkable. The more it can be argued that these differences increase if a real 3D-urolith is investigated. Further sampling biases may evolve and increase the problem of proper sampling:, e.g., if an urolith’s more resistant parts remain intact while ESWL or laser-based stone fragmentation (“dusting”), the weak parts became fully disintegrated and removed from the body as fine-grained sludge—the stone’s fine fraction is lost although its composition may carry important information on the stone’s pathogenesis. Consequently, a “stone analysis” only obtained from the harder remains reveals an incomplete result, a fact that in principle limits its clinical interpretation. Choice of stone fragment is crucial. The extent of the uncertainty of an analysis resulting from potential selection biases should not be underestimated. Thus, sampling should be considered as an important part of the processes of quality assurance and management. Errors made at this early stage of diagnosis finding will affect the analytical result and thus influence the clarification of the underlying pathomechanism. This can lead to an improper metaphylactic strategy potentially causing recurrent stone formation which otherwise would have been prevented. A decision scheme for analysis of urinary stones removed using endoscopic methods is suggested. Sampling strategy (dpeaa)DE-He213 Sampling bias (dpeaa)DE-He213 Representative sampling (dpeaa)DE-He213 Analysis based therapy (dpeaa)DE-He213 Klein, Florian verfasserin aut Fisang, Christian verfasserin aut Enthalten in Urological research Berlin : Springer, 1973 48(2020), 5 vom: 20. Mai, Seite 435-441 (DE-627)254236901 (DE-600)1461962-3 1434-0879 nnns volume:48 year:2020 number:5 day:20 month:05 pages:435-441 https://dx.doi.org/10.1007/s00240-020-01195-6 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_152 GBV_ILN_161 GBV_ILN_171 GBV_ILN_187 GBV_ILN_224 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2057 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2119 GBV_ILN_2129 44.88 ASE AR 48 2020 5 20 05 435-441
allfieldsSound	10.1007/s00240-020-01195-6 doi (DE-627)SPR040928241 (SPR)s00240-020-01195-6-e DE-627 ger DE-627 rakwb eng 610 ASE 44.88 bkl Laube, Norbert verfasserin aut The surgeon’s role on chemical investigations of the composition of urinary stones 2020 Text txt rdacontent Computermedien c rdamedia Online-Ressource cr rdacarrier Abstract The chemical analysis of an urolith is often interpreted as “stone’s composition”. However, it must be taken into consideration, that in most cases, only a fragment of the stone has been sent to the laboratory. In some recurrent patients, stone compositions either vary considerably between episodes or the analytical result obtained from the stone fragment does not fit with the data of e.g. current 24 h-urinalysis or urinary pH-records. The question arises, whether this outcome may be the result of an improper stone sampling scheme. On a simple layered 2D-stone model composed of two mineral phases it is shown, how the choice of a stone fragment process may influence the result of “stone composition”. Depending on the initial position of fragment within the whole stone, the respective calculated analyses can relevantly differ from the whole stone composition as well as strongly between two fragments. Even under the simplified conditions of a 2D-2-component-model “grown” under defined conditions, the differences between the analyses of the different specimens taken from a stone are in part remarkable. The more it can be argued that these differences increase if a real 3D-urolith is investigated. Further sampling biases may evolve and increase the problem of proper sampling:, e.g., if an urolith’s more resistant parts remain intact while ESWL or laser-based stone fragmentation (“dusting”), the weak parts became fully disintegrated and removed from the body as fine-grained sludge—the stone’s fine fraction is lost although its composition may carry important information on the stone’s pathogenesis. Consequently, a “stone analysis” only obtained from the harder remains reveals an incomplete result, a fact that in principle limits its clinical interpretation. Choice of stone fragment is crucial. The extent of the uncertainty of an analysis resulting from potential selection biases should not be underestimated. Thus, sampling should be considered as an important part of the processes of quality assurance and management. Errors made at this early stage of diagnosis finding will affect the analytical result and thus influence the clarification of the underlying pathomechanism. This can lead to an improper metaphylactic strategy potentially causing recurrent stone formation which otherwise would have been prevented. A decision scheme for analysis of urinary stones removed using endoscopic methods is suggested. Sampling strategy (dpeaa)DE-He213 Sampling bias (dpeaa)DE-He213 Representative sampling (dpeaa)DE-He213 Analysis based therapy (dpeaa)DE-He213 Klein, Florian verfasserin aut Fisang, Christian verfasserin aut Enthalten in Urological research Berlin : Springer, 1973 48(2020), 5 vom: 20. Mai, Seite 435-441 (DE-627)254236901 (DE-600)1461962-3 1434-0879 nnns volume:48 year:2020 number:5 day:20 month:05 pages:435-441 https://dx.doi.org/10.1007/s00240-020-01195-6 lizenzpflichtig Volltext GBV_USEFLAG_A SYSFLAG_A GBV_SPRINGER SSG-OLC-PHA GBV_ILN_20 GBV_ILN_22 GBV_ILN_23 GBV_ILN_24 GBV_ILN_31 GBV_ILN_32 GBV_ILN_39 GBV_ILN_40 GBV_ILN_60 GBV_ILN_62 GBV_ILN_65 GBV_ILN_69 GBV_ILN_70 GBV_ILN_73 GBV_ILN_74 GBV_ILN_90 GBV_ILN_95 GBV_ILN_100 GBV_ILN_105 GBV_ILN_110 GBV_ILN_120 GBV_ILN_138 GBV_ILN_152 GBV_ILN_161 GBV_ILN_171 GBV_ILN_187 GBV_ILN_224 GBV_ILN_250 GBV_ILN_267 GBV_ILN_281 GBV_ILN_285 GBV_ILN_293 GBV_ILN_370 GBV_ILN_602 GBV_ILN_702 GBV_ILN_2003 GBV_ILN_2005 GBV_ILN_2006 GBV_ILN_2008 GBV_ILN_2009 GBV_ILN_2010 GBV_ILN_2014 GBV_ILN_2015 GBV_ILN_2020 GBV_ILN_2025 GBV_ILN_2026 GBV_ILN_2027 GBV_ILN_2034 GBV_ILN_2037 GBV_ILN_2057 GBV_ILN_2108 GBV_ILN_2110 GBV_ILN_2119 GBV_ILN_2129 44.88 ASE AR 48 2020 5 20 05 435-441
language	English
source	Enthalten in Urological research 48(2020), 5 vom: 20. Mai, Seite 435-441 volume:48 year:2020 number:5 day:20 month:05 pages:435-441
sourceStr	Enthalten in Urological research 48(2020), 5 vom: 20. Mai, Seite 435-441 volume:48 year:2020 number:5 day:20 month:05 pages:435-441
format_phy_str_mv	Article
institution	findex.gbv.de
topic_facet	Sampling strategy Sampling bias Representative sampling Analysis based therapy
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container_title	Urological research
authorswithroles_txt_mv	Laube, Norbert @@aut@@ Klein, Florian @@aut@@ Fisang, Christian @@aut@@
publishDateDaySort_date	2020-05-20T00:00:00Z
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author	Laube, Norbert
spellingShingle	Laube, Norbert ddc 610 bkl 44.88 misc Sampling strategy misc Sampling bias misc Representative sampling misc Analysis based therapy The surgeon’s role on chemical investigations of the composition of urinary stones
authorStr	Laube, Norbert
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format	electronic Article
dewey-ones	610 - Medicine & health
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illustrated	Not Illustrated
issn	1434-0879
topic_title	610 ASE 44.88 bkl The surgeon’s role on chemical investigations of the composition of urinary stones Sampling strategy (dpeaa)DE-He213 Sampling bias (dpeaa)DE-He213 Representative sampling (dpeaa)DE-He213 Analysis based therapy (dpeaa)DE-He213
topic	ddc 610 bkl 44.88 misc Sampling strategy misc Sampling bias misc Representative sampling misc Analysis based therapy
topic_unstemmed	ddc 610 bkl 44.88 misc Sampling strategy misc Sampling bias misc Representative sampling misc Analysis based therapy
topic_browse	ddc 610 bkl 44.88 misc Sampling strategy misc Sampling bias misc Representative sampling misc Analysis based therapy
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title	The surgeon’s role on chemical investigations of the composition of urinary stones
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title_full	The surgeon’s role on chemical investigations of the composition of urinary stones
author_sort	Laube, Norbert
journal	Urological research
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author_browse	Laube, Norbert Klein, Florian Fisang, Christian
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doi_str_mv	10.1007/s00240-020-01195-6
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title_sort	surgeon’s role on chemical investigations of the composition of urinary stones
title_auth	The surgeon’s role on chemical investigations of the composition of urinary stones
abstract	Abstract The chemical analysis of an urolith is often interpreted as “stone’s composition”. However, it must be taken into consideration, that in most cases, only a fragment of the stone has been sent to the laboratory. In some recurrent patients, stone compositions either vary considerably between episodes or the analytical result obtained from the stone fragment does not fit with the data of e.g. current 24 h-urinalysis or urinary pH-records. The question arises, whether this outcome may be the result of an improper stone sampling scheme. On a simple layered 2D-stone model composed of two mineral phases it is shown, how the choice of a stone fragment process may influence the result of “stone composition”. Depending on the initial position of fragment within the whole stone, the respective calculated analyses can relevantly differ from the whole stone composition as well as strongly between two fragments. Even under the simplified conditions of a 2D-2-component-model “grown” under defined conditions, the differences between the analyses of the different specimens taken from a stone are in part remarkable. The more it can be argued that these differences increase if a real 3D-urolith is investigated. Further sampling biases may evolve and increase the problem of proper sampling:, e.g., if an urolith’s more resistant parts remain intact while ESWL or laser-based stone fragmentation (“dusting”), the weak parts became fully disintegrated and removed from the body as fine-grained sludge—the stone’s fine fraction is lost although its composition may carry important information on the stone’s pathogenesis. Consequently, a “stone analysis” only obtained from the harder remains reveals an incomplete result, a fact that in principle limits its clinical interpretation. Choice of stone fragment is crucial. The extent of the uncertainty of an analysis resulting from potential selection biases should not be underestimated. Thus, sampling should be considered as an important part of the processes of quality assurance and management. Errors made at this early stage of diagnosis finding will affect the analytical result and thus influence the clarification of the underlying pathomechanism. This can lead to an improper metaphylactic strategy potentially causing recurrent stone formation which otherwise would have been prevented. A decision scheme for analysis of urinary stones removed using endoscopic methods is suggested.
abstractGer	Abstract The chemical analysis of an urolith is often interpreted as “stone’s composition”. However, it must be taken into consideration, that in most cases, only a fragment of the stone has been sent to the laboratory. In some recurrent patients, stone compositions either vary considerably between episodes or the analytical result obtained from the stone fragment does not fit with the data of e.g. current 24 h-urinalysis or urinary pH-records. The question arises, whether this outcome may be the result of an improper stone sampling scheme. On a simple layered 2D-stone model composed of two mineral phases it is shown, how the choice of a stone fragment process may influence the result of “stone composition”. Depending on the initial position of fragment within the whole stone, the respective calculated analyses can relevantly differ from the whole stone composition as well as strongly between two fragments. Even under the simplified conditions of a 2D-2-component-model “grown” under defined conditions, the differences between the analyses of the different specimens taken from a stone are in part remarkable. The more it can be argued that these differences increase if a real 3D-urolith is investigated. Further sampling biases may evolve and increase the problem of proper sampling:, e.g., if an urolith’s more resistant parts remain intact while ESWL or laser-based stone fragmentation (“dusting”), the weak parts became fully disintegrated and removed from the body as fine-grained sludge—the stone’s fine fraction is lost although its composition may carry important information on the stone’s pathogenesis. Consequently, a “stone analysis” only obtained from the harder remains reveals an incomplete result, a fact that in principle limits its clinical interpretation. Choice of stone fragment is crucial. The extent of the uncertainty of an analysis resulting from potential selection biases should not be underestimated. Thus, sampling should be considered as an important part of the processes of quality assurance and management. Errors made at this early stage of diagnosis finding will affect the analytical result and thus influence the clarification of the underlying pathomechanism. This can lead to an improper metaphylactic strategy potentially causing recurrent stone formation which otherwise would have been prevented. A decision scheme for analysis of urinary stones removed using endoscopic methods is suggested.
abstract_unstemmed	Abstract The chemical analysis of an urolith is often interpreted as “stone’s composition”. However, it must be taken into consideration, that in most cases, only a fragment of the stone has been sent to the laboratory. In some recurrent patients, stone compositions either vary considerably between episodes or the analytical result obtained from the stone fragment does not fit with the data of e.g. current 24 h-urinalysis or urinary pH-records. The question arises, whether this outcome may be the result of an improper stone sampling scheme. On a simple layered 2D-stone model composed of two mineral phases it is shown, how the choice of a stone fragment process may influence the result of “stone composition”. Depending on the initial position of fragment within the whole stone, the respective calculated analyses can relevantly differ from the whole stone composition as well as strongly between two fragments. Even under the simplified conditions of a 2D-2-component-model “grown” under defined conditions, the differences between the analyses of the different specimens taken from a stone are in part remarkable. The more it can be argued that these differences increase if a real 3D-urolith is investigated. Further sampling biases may evolve and increase the problem of proper sampling:, e.g., if an urolith’s more resistant parts remain intact while ESWL or laser-based stone fragmentation (“dusting”), the weak parts became fully disintegrated and removed from the body as fine-grained sludge—the stone’s fine fraction is lost although its composition may carry important information on the stone’s pathogenesis. Consequently, a “stone analysis” only obtained from the harder remains reveals an incomplete result, a fact that in principle limits its clinical interpretation. Choice of stone fragment is crucial. The extent of the uncertainty of an analysis resulting from potential selection biases should not be underestimated. Thus, sampling should be considered as an important part of the processes of quality assurance and management. Errors made at this early stage of diagnosis finding will affect the analytical result and thus influence the clarification of the underlying pathomechanism. This can lead to an improper metaphylactic strategy potentially causing recurrent stone formation which otherwise would have been prevented. A decision scheme for analysis of urinary stones removed using endoscopic methods is suggested.
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title_short	The surgeon’s role on chemical investigations of the composition of urinary stones
url	https://dx.doi.org/10.1007/s00240-020-01195-6
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up_date	2024-07-03T19:09:31.716Z
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