Each year, about 140 patients come to the Cincinnati Children’s Stone Center, where a multidisciplinary team works together in one location to provide well-coordinated, personalized care. It’s convenient and efficient for patients and their families—but is there a clinical benefit? The answer, according to a recently published study, is yes.

The retrospective cohort study included 182 Stone Center patients who met the inclusion criteria of being under 21 years of age (mean age was 14) and having more than six months of follow-up. Specifically, the study found that during the one year before and at any time after the first visit:

• The number of patients undergoing surgical procedures (such as ureteroscopy and extracorporeal shock wave lithotripsy) decreased from 40% to 18%.
• The average number of emergency department visits per year decreased from 1.5 to 0.5.
• Computed tomography usage decreased from 32% to 25%.

In addition to showing clear clinical benefit, these findings translate into significantly lower medical bills, in the sense that patients who receive care at the multidisciplinary Stone Center are able to reduce their ED visits by an average of one visit per year and potentially avoid expensive surgical procedures.

Many specialists, one location

The Cincinnati Children’s Stone Center opened in 2014, in response to a rise in urolithiasis among pediatric patients. It is a joint venture of the Divisions of Pediatric Nephrology and Urology, and includes physicians, nurses, dietitians, genetic counselors and social workers from emergency medicine, human genetics, interventional radiology, laboratory medicine, radiology, nephrology and urology. The team develops a personalized treatment plan that can include medication and/or surgery, but always includes extensive education and recommendations to help children reduce their risk of recurrent stones and minimize complications.

The study’s principal investigator, William (Bob) DeFoor, MD, MPH a pediatric urologist, presented results from the study at the American Urological Association’s Annual Meeting in May 2018.