{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T15:21:48Z","timestamp":1787671308584,"version":"build-2736575974"},"reference-count":39,"publisher":"PeerJ","license":[{"start":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T00:00:00Z","timestamp":1787616000000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0"}],"funder":[{"name":"PLA Air Force Medical University","award":["2024KXKT099"],"award-info":[{"award-number":["2024KXKT099"]}]},{"name":"Xijing Hospital Discipline Promotion Program General Clinical Research Project","award":["XJZT27LY17"],"award-info":[{"award-number":["XJZT27LY17"]}]},{"name":"Shaanxi Provincial Key Research and Development Program General Project","award":["S2025-YF-YBSF-0349"],"award-info":[{"award-number":["S2025-YF-YBSF-0349"]}]},{"name":"Air Force Medical University Xijing Hospital Basic Innovation Research Institute Project","award":["LHJJ24JH24"],"award-info":[{"award-number":["LHJJ24JH24"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The rising burden of urolithiasis in Southeast Asia and the lack of efficient risk-screening tools for low-resource primary care, such as those in Laos, motivated the development and external validation of a pragmatic nomogram integrating accessible environmental, behavioral, and clinical factors for in-hospital urolithiasis risk stratification, with long-term goal of application in grassroots screening.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A retrospective study was conducted with 665 consecutive inpatients (\u226518 years, local residence \u22656 months) at a Lao Military Hospital (March 2024\u2013February 2025). Data were collected using standardized questionnaires and electronic medical records. Least Absolute Shrinkage and Selection Operator (LASSO) regression selected predictors; nomogram performance was assessed by discrimination (area under the curve (AUC)), calibration (Brier score and Hosmer\u2013Lemeshow test), and clinical utility (decision curve analysis (DCA)).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Urolithiasis prevalence was 23.0% (153\/665). Independent predictors included age (30\u201359 years, OR = 1.54; \u226560 years, OR = 1.13), sex (OR = 0.59), rural residence (OR = 0.52), high water intake (&gt;1,500 mL\/day, OR = 0.02), high sodium consumption (&gt;10 g\/day, OR = 21.90), and elevated blood calcium (OR = 9.12). The nomogram presented stable predictive performance, with an AUC of 0.882\u20130.907, Brier score of 0.086\u20130.111 (acceptable calibration, Hosmer\u2013Lemeshow\n                      <jats:italic>p<\/jats:italic>\n                      = 0.198\u20130.892), and optimal clinical threshold at 0.20.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>This externally validated nomogram uses six accessible environmental, behavioral, and clinical factors to stratify urolithiasis risk in Laos. At present, it helps guide targeted referral and optimize s resource allocation for hospitalized patients in resource\u2014limited settings, while its application in primary care and among broader Southeast Asian populations remains to be prospectively evaluated.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.7717\/peerj.21644","type":"journal-article","created":{"date-parts":[[2026,8,25]],"date-time":"2026-08-25T14:41:03Z","timestamp":1787668863000},"page":"e21644","source":"Crossref","is-referenced-by-count":0,"title":["Development and external validation of a pragmatic nomogram for point-of-care urolithiasis screening in resource-limited settings of Laos: a multicenter retrospective cohort study"],"prefix":"10.7717","volume":"14","author":[{"given":"Banchao","family":"Shen","sequence":"first","affiliation":[{"name":"Department of Urology, Xijing Hospital, Air Force Medical University, Xi\u2019an, Shaanxi, China"},{"name":"Department of Urology, No. 988 Hospital of Joint 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