title: Impact of learning curve on efficacy of shock wave lithotripsy.
abstract: BACKGROUND
  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.
  
  
  CONCLUSIONS
  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.
authors.affiliation: Department of Urology, University of Minnesota, MN, USA.
authors.forename: Courtney
authors.initials: C
authors.lastname: Lee
authors.forename: Sara L
authors.initials: SL
authors.lastname: Best
authors.forename: Roland
authors.initials: R
authors.lastname: Ugarte
authors.forename: Manoj
authors.initials: M
authors.lastname: Monga
mesh_terms: D000488:Allied Health Personnel / Q000706:statistics & numerical data*; D018572:Disease-Free Survival; D004651:Employment / Q000706:statistics & numerical data*; D005260:Female; D019220:High-Energy Shock Waves / Q000627:therapeutic use*; D006801:Humans; D008096:Lithotripsy / Q000706:statistics & numerical data*; D008297:Male; D008875:Middle Aged; D008910:Minnesota; D015995:Prevalence; D011361:Professional Competence / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D016896:Treatment Outcome; D014481:United States / Q000453:epidemiology; D014545:Urinary Calculi / Q000453:epidemiology* / Q000628:therapy*