JournalFeed PubMetric Report
Analysis Source: PDF full text + PubMed metadata
JournalFeed PubMetric Score
High Confidence
PubMetric Score Breakdown
Addresses a common ED presentation with potential to change practice.
Prospective multicenter study with clear methodology.
Low risk of bias due to prospective design and clear outcome definitions.
Statistically significant and clinically meaningful findings.
First study of its kind; requires external validation.
Easily implemented in ED settings with POCUS availability.
Funding present; COI disclosure present.
Critical Appraisal
Study Identification
Background
Study Question
Study Design & Conduct
Prospective / Retrospective: Prospective
Multicenter: Yes
Unit of Allocation: Not applicable
Unit of Analysis: Patients
Randomization Method: Not applicable
Allocation Concealment: Not applicable
Blinding: Not applicable
Follow-up Duration: 30 days
Population
- Adult patients with suspected uncomplicated acute renal colic
- Renal colic considered most probable diagnosis by treating physician
- Suspicion of urinary tract infection
- Hemodynamic instability
- Single kidney
- Renal transplantation
- Pregnancy
- Age below 18 years
- Lack of consent
Number Enrolled: 168
Number Analyzed: 168
Key Baseline Characteristics
Sex: 49% female
Disease Severity: Not reported
Care Setting Distribution: Emergency Department
Additional Baseline Characteristics
- 45% with history of renal colic
Exposures / Interventions
Description: POCUS examination
Definition / Dose: Assessment of hydronephrosis severity
Timing: Upon ED presentation
Classification Method: Performed by trained emergency physicians
Protocolized / Discretionary: Protocolized
Description: Not applicable
Definition: Not applicable
Outcomes & Results
Primary Outcomes
Definition: In-hospital admission, urological procedure within 24 hours after ED admission, or new ED admission within 30 days leading to urgent urological procedure within 24 hours.
Time Point: 30 days
Measurement Method: Medical record review and follow-up calls
Results: 15% required urgent urological care
Secondary Outcomes
Definition: Rate of alternative diagnoses identified
Time Point: During ED visit
Measurement Method: POCUS examination
Results: Not reported
Risk of Bias
Risk of Bias - ROBINS-I
- Confounding (Low): Study controlled for major confounders through multivariable analysis.
- Selection of Participants (Low): Consecutive patients were included, reducing selection bias.
- Classification of Interventions (Low): Interventions were clearly defined and consistently applied.
- Deviations from Intended Interventions (Low): Interventions were protocolized and deviations were unlikely.
- Missing Data (Low): No missing data reported for primary outcomes.
- Measurement of Outcomes (Low): Outcomes were clearly defined and measured consistently.
- Selection of the Reported Result (Low): All relevant outcomes were reported.
Transparency
COI Statement Present: TRUE
PubMetric Brief
Take-Home Message
The ECOLIC score, combining POCUS and clinical findings, helps identify low-risk renal colic patients who may not need urgent urological care.
Study Summary
This multicenter prospective study developed the ECOLIC score to predict the need for urgent urological care in patients with suspected uncomplicated acute renal colic. Conducted in three French EDs, the study included 168 patients who underwent POCUS to assess hydronephrosis. The primary outcome was urgent urological care within 30 days. Three predictors were identified: age over 65 years, moderate to severe hydronephrosis, and persistent pain 4 hours post-analgesia. The ECOLIC score (0-6) showed a score ≤ 1 had a 98% negative predictive value for urgent care. This tool could help safely discharge low-risk patients without immediate CT or urological referral, pending external validation.
Citation
Point-of-care ultrasound for risk stratification of urgent urological care in acute uncomplicated renal colic
. CJEM. 2025;27(12):984-994. PMID: 41138020