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Centre for Evidence-
Based Medicine

Prognosis: Clinical Scenario

A 58 year old male had several weeks of intermiitent right loin to groin pain, but no microscopic hematuria, and negative X-ray, IVP and CT scan. Eventually he passed a 1mm calcium oxalate stone. Electrolytes, renal function, and urine microscopy and culture were all normal. We discussed prevention and he wanted to know the chances of recurrence. We formulate the clinical question, what is the risk of recurrence of ureteric calculus after a single episode in a middle aged male?

Searching terms and evidence source:
(renal OR ureteric) AND (calculus OR stone* OR colic) AND recurrence AND year* - search in PROGNOSIS section of PubMed Clinical Queries (emphasising "sensitivity")

Read the article and decide:

  1. Is the evidence from this trial valid?
  2. If valid, is this evidence important?
  3. If valid and important, can you apply this evidence in caring for your patient?

Continue to completed worksheet