{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,11]],"date-time":"2026-06-11T10:59:36Z","timestamp":1781175576830,"version":"3.54.1"},"reference-count":21,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2026,4,14]],"date-time":"2026-04-14T00:00:00Z","timestamp":1776124800000},"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":[[2026,7,1]]},"abstract":"<jats:sec>\n                    <jats:title>Aim of the Study:<\/jats:title>\n                    <jats:p>This study aimed to evaluate the performance of machine learning (ML) algorithms integrated with explainable artificial intelligence (XAI) techniques in predicting outcomes following flexible ureteroscopy (fURSL) in children. By identifying significant preoperative predictors, the goal was to improve individualized surgical risk assessment and planning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Materials and Methods:<\/jats:title>\n                    <jats:p>A retrospective analysis was conducted on 391 pediatric patients treated with fURSL for urolithiasis across 8 high-volume centers (2017\u20132021). Preoperative, intraoperative, and postoperative data were collected. 15 ML models were trained to predict five postoperative outcomes: fever, hematuria, sepsis, residual fragments (RF), and reintervention. A multitask artificial neural network (ANN) was also developed. Performance was evaluated using validation accuracy, confusion matrices, and classification reports. SHapley Additive exPlanations values and decision trees were used for model interpretability.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>Ensemble models outperformed others, with Gradient Boosting achieving 92.4% validation accuracy in predicting postoperative fever, Extra Trees achieving 91.1% for hematuria, and XGBoost reaching 96.0% for sepsis. Predictors included preoperative infections, stone burden, operative duration, and anatomical anomalies. For RF, Gradient Boost and Random Forest yielded strong results with up to 93.7% accuracy. Reintervention was best predicted by Random Forest, with RF as the strongest predictor. XAI techniques provided transparent, clinically interpretable models that aligned with medical reasoning.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>ML models demonstrated high accuracy in predicting adverse postoperative outcomes in pediatric ureteroscopy, with ensemble methods showing the best performance. Integration with XAI enhanced interpretability, supporting clinical decision-making. These findings underscore the potential of ML and XAI to inform personalized treatment strategies, though further prospective validation is needed to develop robust, generalizable predictive tools.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/08927790261441731","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T04:42:32Z","timestamp":1776228152000},"page":"823-830","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":0,"title":["Predicting Postoperative Outcomes in Pediatric Ureteroscopy Using Machine Learning and Explainable AI\u2014EAU Endourology Vision-AI Study"],"prefix":"10.1177","volume":"40","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2031-347X","authenticated-orcid":false,"given":"Carlotta","family":"Nedbal","sequence":"first","affiliation":[{"name":"Polytechnic University Le Marche, Ancona, Italy."},{"name":"IRCCS San Gerardo dei Tintori, Monza, Italy."},{"name":"Endourology Section, European Association of Urology, Arnhem, The Netherlands."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vineet","family":"Gauhar","sequence":"additional","affiliation":[{"name":"Endourology Section, European Association of Urology, Arnhem, The Netherlands."},{"name":"Department of Urology, Ng Teng Fong General Hospital, Singapore, Singapore."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria Florencia","family":"Frascheri","sequence":"additional","affiliation":[{"name":"University Hospital Southampton NHS Foundation Trust, Southampton, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shilpa","family":"Gite","sequence":"additional","affiliation":[{"name":"Department of Engineering, Symbiosis Institute of Technology, Pune, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Het","family":"Sevalia","sequence":"additional","affiliation":[{"name":"Department of Engineering, Symbiosis Institute of Technology, Pune, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ratan","family":"Maurya","sequence":"additional","affiliation":[{"name":"Department of Engineering, Symbiosis Institute of Technology, Pune, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Prisha","family":"Jaiswal","sequence":"additional","affiliation":[{"name":"Department of Engineering, Symbiosis Institute of Technology, Pune, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khushi","family":"Kashyap","sequence":"additional","affiliation":[{"name":"Department of Engineering, Symbiosis Institute of Technology, Pune, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniele","family":"Castellani","sequence":"additional","affiliation":[{"name":"Department of Medicine and Surgery, LUM University, Casamassima, Bari, Italy."},{"name":"Urology unit, Ecclesiastical Entity Regional General Hospital \u201cF. Miulli\u201d, Acquaviva delle Fonti, Bari, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrea","family":"Gregori","sequence":"additional","affiliation":[{"name":"IRCSS San Gerardo, Monza, Italy."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fr\u00e9d\u00e9ric","family":"Panthier","sequence":"additional","affiliation":[{"name":"Endourology Section, European Association of Urology, Arnhem, The Netherlands."},{"name":"GRC Urolithiasis No. 20, Sorbonne University, Tenon Hospital, Paris, France."},{"name":"PIMM, UMR 8006 CNRS-Arts et M\u00e9tiers ParisTech, Paris, France."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yiloren","family":"Tanidir","sequence":"additional","affiliation":[{"name":"Department of Urology, Marmara University School of Medicine, Istanbul, Turkey."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anil","family":"Shrestha","sequence":"additional","affiliation":[{"name":"Department of Urology, National Academy of Medical Sciences, Bir Hospital, Kathmandu, Nepal."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vikram","family":"Sridharan","sequence":"additional","affiliation":[{"name":"Department of Urology, Sree Paduka Speciality Hospital, Thillai Nagar, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abhishek","family":"Singh","sequence":"additional","affiliation":[{"name":"Muljibhai Patel Urological Hospital, Nadiad, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Boyke","family":"Soebhali","sequence":"additional","affiliation":[{"name":"Department of Urology, Abdul Wahab Sjahranie Hospital Medical Faculty, Muliawarman University, Samarinda, Indonesia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed Amine","family":"Lakmichi","sequence":"additional","affiliation":[{"name":"Department of Urology, University Hospital Mohammed the VIth of Marrakesh, Marrakesh, Morocco."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saeed Biin","family":"Hamri","sequence":"additional","affiliation":[{"name":"Department of Surgery, King Abdullah International Medical Research Centre, Riyadh, Saudi Arabia."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nithesh","family":"Naik","sequence":"additional","affiliation":[{"name":"Department of Engineering, Manipal Academy of Higher Education, Manipal, India."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6248-6478","authenticated-orcid":false,"given":"Bhaskar Kumar","family":"Somani","sequence":"additional","affiliation":[{"name":"Endourology Section, European Association of Urology, Arnhem, The Netherlands."},{"name":"University Hospital Southampton NHS Foundation Trust, Southampton, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,4,14]]},"reference":[{"issue":"2","key":"e_1_3_2_2_1","first-page":"201","article-title":"Urolithiasis in the pediatric population - current opinion on epidemiology, patophysiology, diagnostic evaluation and treatment","volume":"22","author":"Jobs K","year":"2018","unstructured":"1.Jobs K, , Rakowska M, , Paturej A. 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