{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,26]],"date-time":"2026-09-26T00:22:09Z","timestamp":1790382129634,"version":"4.1.0"},"reference-count":29,"publisher":"SAGE Publications","issue":"2","license":[{"start":{"date-parts":[[2021,2,1]],"date-time":"2021-02-01T00:00:00Z","timestamp":1612137600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Endourology"],"published-print":{"date-parts":[[2021,2]]},"abstract":"<jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>We introduced a nurse-led telephone-based virtual stone clinic (VSC) follow-up for the surveillance of patients with asymptomatic renal calculi or those at a high risk of recurrent kidney stone disease (KSD). The aim of this study was to look at the outcomes of VSC and its role in the post-COVID era.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>Prospective outcomes audit was done for all patients referred to the VSC for a 6-year period (March 2014\u2013April 2020). VSC is led by specialist stone nurses for on-going surveillance of KSD patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>A total of 290 patients were seen (468 individual appointments; 1.6\u2009\u00b1\u20091.0 per patient), with a mean age of 57.0\u2009\u00b1\u200915.8 years (range: 17\u201392) and a men\u2013women ratio of 3:2. The referral was for surveillance of asymptomatic small renal stones (230, 79.3%); history of recurrent stone disease (45, 15.5%); solitary kidneys (5, 1.7%); cystine stones; young age; and other conditions (10, 3.4%). The mean stone size was 5.0\u2009\u00b1\u20092.7\u2009mm, followed up with kidney, ureter, and bladder radiograph (225, 77.6%) and ultrasound scan (USS) (65, 22.4%), for median duration of 12 months (range: 3\u201324 months). At the end, 132 patients (45.6%) remained in VSC, 106 (36.6%) were discharged, 47 (16.2%) returned to face-to-face clinic or treatment, and 5 (1.7%) had emergency admissions. Of 47 patients who returned, 23 (48.9%) developed new symptoms, 21 (44.6%) had stone growth, and 3 defaulted to face-to-face appointment. Thirty-five patients needed surgical intervention (URS-21, SWL-13, and PCNL-1) and 10 were managed conservatively. VSC reduced the cost per clinic appointment from \u00a327.9 to \u00a32 per patient (93% reduction), equating to a total saving of \u00a312,006 for the study period.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>Nurse-led VSC not only provided a safe follow-up but also allowed to substantially reduce the cost of treatment by allowing patients to be either discharged or return to a face-to-face clinic or surgical intervention if needed. Post-COVID, this model using telemedicine will have a much wider uptake and further help to optimize health care resources.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1089\/end.2020.0708","type":"journal-article","created":{"date-parts":[[2020,7,31]],"date-time":"2020-07-31T03:29:03Z","timestamp":1596166143000},"page":"200-205","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":16,"title":["Lessons Learnt (Clinical Outcomes and Cost Savings) from Virtual Stone Clinic and Their Application in the Era Post-COVID-19: Prospective Outcomes over a 6-Year Period from a University Teaching Hospital"],"prefix":"10.1177","volume":"35","author":[{"given":"Thomas","family":"Hughes","sequence":"first","affiliation":[{"name":"Department of Urology, University Hospital Southampton, Southampton, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amelia","family":"Pietropaolo","sequence":"additional","affiliation":[{"name":"Department of Urology, University Hospital Southampton, Southampton, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Matthew","family":"Archer","sequence":"additional","affiliation":[{"name":"Department of Urology, University Hospital Southampton, Southampton, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tania","family":"Davis","sequence":"additional","affiliation":[{"name":"Department of Urology, University Hospital Southampton, Southampton, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Loretta","family":"Tear","sequence":"additional","affiliation":[{"name":"Department of Urology, University Hospital Southampton, Southampton, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhaskar K.","family":"Somani","sequence":"additional","affiliation":[{"name":"Department of Urology, University Hospital Southampton, Southampton, United Kingdom."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2021,2,1]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1111\/bju.13520"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1159\/000449510"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.urology.2014.06.037"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2017.0123"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2019-032094"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1089\/end.2015.0547"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1111\/bju.14991"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0302-2838(03)00415-9"},{"key":"e_1_3_3_10_2","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-158-7-201304020-00005"},{"key":"e_1_3_3_11_2","doi-asserted-by":"publisher","DOI":"10.1038\/ki.2012.320"},{"key":"e_1_3_3_12_2","article-title":"Medical Management of Stones: AUA\/Endourology Society Guideline [Internet]","author":"American Urological Association","year":"2019","unstructured":"American Urological Association. 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