King's College London

Research portal

Development and content validation of the percutaneous nephrolithotomy assessment score

Research output: Contribution to journalArticlepeer-review

Kate Quirke, Abdullatif Aydın, Matthew Bultitude, Kemal Sarıca, Jonathan Glass, Azhar Khan, Howard Marsh, Samih Al-Hayek, Oliver Wiseman, Jake Patterson, Jonathan Makanjuola, Andreas Skolarikos, Bhaskar Somani, Muhammad Shamim Khan, Prokar Dasgupta, Kamran Ahmed

Original languageEnglish
Pages (from-to)960-964
Number of pages5
JournalInternational Journal of Urology
Issue number11
Accepted/In press1 Jan 2020
PublishedNov 2020

King's Authors


Objectives: To develop and content validate a percutaneous nephrolithotomy assessment score, taking into consideration the procedure-specific risks. Methods: This prospective international study utilized the Healthcare Failure Mode and Effect Analysis to systematically outline percutaneous nephrolithotomy and failure modes for each step. A total of 25 h was spent observing percutaneous nephrolithotomy carried out by six expert surgeons. Hazard analysis scoring was carried out by 11 experts. It was determined if the steps were single point weaknesses. Single point weaknesses and those assigned a hazard score ≥4 were included in the percutaneous nephrolithotomy assessment score. The tool was then content validated by 16 experts from 10 countries. Results: Application of the Healthcare Failure Mode and Effect Analysis identified 64 failure modes; 37 failure modes had a hazard score ≥4. After adaptations based on expert feedback the final percutaneous nephrolithotomy assessment score was developed containing 10 phases, 21 processes and 47 subprocesses. All participants agreed that the tool contained pertinent procedural steps. Conclusions: This study has developed and shown the international content validity of a novel percutaneous nephrolithotomy assessment score. The tool can be utilized in modular operating room training to quantify operator progress, and can be used in conjunction with other modules as part of a complete percutaneous nephrolithotomy curriculum for trainees.

View graph of relations

© 2020 King's College London | Strand | London WC2R 2LS | England | United Kingdom | Tel +44 (0)20 7836 5454