CLOC Score: External validation of the CholeS conversion from laparoscopic to open cholecystectomy (CLOC) risk score in Aotearoa New Zealand: a validation study

Risk prediction tools only improve equity if they work in the populations we actually serve.

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This national STRATA and CholeS Collaborative study externally validated the CholeS conversion from laparoscopic to open cholecystectomy (CLOC) risk score in Aotearoa New Zealand.

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Using multicentre data, the study confirmed that the CLOC score performs well in the Aotearoa context, accurately identifying patients at higher risk of conversion — an outcome associated with longer operative time, increased length of stay, and greater resource use. Importantly, this validation shows that an internationally derived tool can be applied safely and meaningfully within our public health system.

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The equity relevance is clear. Conversion risk is not just a technical issue — it affects theatre allocation, staffing, postoperative care planning, and patient counselling, and may disproportionately impact patients presenting later, with more severe disease, or from regions with limited access to early surgery. Applying a validated risk tool helps ensure that service planning and peri‑operative decision‑making are based on clinical need rather than clinician experience or centre‑specific practice alone.

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By validating the CLOC score locally, this work supports more consistent, anticipatory, and equitable surgical care — aligning resources with risk and reducing avoidable variation in outcomes across hospitals.

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Read the full article here: https://pubmed.ncbi.nlm.nih.gov/38525949/