Performance of ‘Triple-D’ and ‘Quadruple-D’ Scores Compared to a Regression-Based Predictive Model for Treatment Outcomes in Extracorporeal Shock Wave Lithotripsy: A 1000-Treatment Series Using the Dornier Compact Delta III Pro

A retrospective cohort study was conducted including 1,000 adult patients undergoing ESWL using the Dornier Compact Delta® III Pro lithotripter at a tertiary hospital in Doha, Qatar, between May 2022 and November 2023. Data on demographics, key stone parameters (size, density, skin-to-stone distance), and treatment details were collected. Key predictors of ESWL treatment failure were evaluated using multivariable logistic regression with internal validation. The predictive performances of the Triple-D, Quadruple-D, and regression-based models were compared using receiver operating characteristic (ROC) analysis, with differences assessed by DeLong’s test. Model calibration and clinical utility were further examined through calibration plots and decision curve analysis (DCA).