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Impact of Learning Curve on Efficacy of Shock Wave Lithotripsy

Introduction The purpose of this study was to evaluate the impact of a radiographer’s learning curve on extracorporeal shock wave lithotripsy (SWL) efficacy.

Methods Five registered technologists who were certified to assist in SWL procedures but had no prior lithotripter experience were evaluated during a 4-year period. Stone-free (no residual fragments on plain radiographic imaging), re-treatment and post-SWL procedure rates were evaluated for the first 3 years of radiographer employment.

Results The overall stone-free rate increased from 55% (efficiency quotient [EQ] 45) in the first year to 68% (EQ 50) in the third year. The treatment success rate for the lower calyx increased from 50% (EQ 41) in the first year to 62% (EQ 44) in the third year. There was no difference in re-treatment or post-SWL procedure rates.

Conclusion Efficacy with SWL, as measured by stone-free rates, improved with increasing experience of the radiographer. Ongoing supervision and mentorship might be helpful in the first year of service.