{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T08:17:58Z","timestamp":1774945078387,"version":"3.50.1"},"reference-count":38,"publisher":"PAGEPress Publications","issue":"1","license":[{"start":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T00:00:00Z","timestamp":1774915200000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Arch Ital Urol Androl"],"abstract":"<jats:p>Introduction: Urolithiasis affects up to 10% of the population and recurs in more than 50% of cases within ten years. Urinary pH plays a pivotal role in stone prevention, but dipstick testing, the most commonly used method, lacks accuracy, precision and reliability. Only portable digital pH meters classified as medical devices offer superior accuracy, sensitivity, specificity, and resolution, enabling more reliable urinary pH monitoring than dipstick testing. Nevertheless, their comparative cost-effectiveness remains unclear.\u00a0Methods: we conducted a systematic review and cost-effectiveness analysis comparing a portable digital pH meter with dipsticks for urinary pH monitoring in recurrent stone formers. Following PrIsMA 2020 guidelines, studies reporting on accuracy, precision, or costs were included. Data were pooled using random-effects models. Cost estimates were derived from the European market sources and adjusted for inflation. Outcomes included analytical validity, cost per effective unit, number needed to treat (NNT), and cost per quality-adjusted life-year (QALy) gained.Results: Thirteen studies involving 2,801 participants were included in the quantitative synthesis. The portable digital pH meter consistently outperformed dipsticks across all evaluated parameters, demonstrating higher explained variance (r2 0.97 vs 0.54), finer resolution (0.1 vs 0.5 pH units), and lower systematic bias (0.06 vs 0.36). The cost per effective unit was lowest for the portable digital pH meter (\u20ac 179) compared with once-daily (\u20ac 354) and twice-daily dipstick testing (\u20ac 708). In compliance-adjusted models, the cost per lithiasis episode prevented was \u20ac 590 for the portable digital pH meter vs \u20ac1,169 and \u20ac 2.337 for dipsticks. In a simulated 1.,000-patient cohort, the portable digital pH meter yielded the lowest total costs (\u20ac 601.376) and the greatest QALy gain (17.84), demonstrating a dominant result, being both more effective and less costly than all alternatives.Conclusions: The portable digital pH meter demonstrated superior analytical performance and cost-effectiveness compared with dipsticks for urinary pH monitoring. Its broader implementation may enhance preventive strategies, reduce stone recurrence, and decrease the overall healthcare burden associated with recurrent urolithiasis. Considering these findings, the portable digital pH meters may warrant consideration for inclusion in major clinical guidelines on urolithiasis and for reimbursement by healthcare systems, potentially supporting their broader adoption in clinical practice.<\/jats:p>","DOI":"10.4081\/aiua.2026.14746","type":"journal-article","created":{"date-parts":[[2026,3,31]],"date-time":"2026-03-31T06:54:10Z","timestamp":1774940050000},"source":"Crossref","is-referenced-by-count":0,"title":["Diagnostic performance and cost-effectiveness of portable digital pH meters and traditional dipsticks for urine pH monitoring in patients at risk of recurrent urolithiasis"],"prefix":"10.4081","volume":"98","author":[{"given":"Juan Antonio","family":"Gal\u00e1n","sequence":"first","affiliation":[{"name":"Department of Urology, General University Hospital Dr Balmis, Alicante"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Athanasios","family":"Papatsoris","sequence":"additional","affiliation":[{"name":"2nd University Department of Urology, Sismanoglio Hospital, Athens"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Guzm\u00e1n","family":"Ordaz","sequence":"additional","affiliation":[{"name":"Hospital La Fe de Valencia"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bernat","family":"Isern","sequence":"additional","affiliation":[{"name":"Renal Lithiasis and Pathological Calcification Group (LiRCaP), Research Institute of Health Sciences (IUNICS), University of the Balearic Islands, Palma"},{"name":"Health Research Institute of the Balearic Islands (IdISBa), Palma"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2549","published-online":{"date-parts":[[2026,3,31]]},"reference":[{"key":"222495","doi-asserted-by":"crossref","unstructured":"1. 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