STUDY OBJECTIVE: The aims of the study were to prospectively evaluate the Alvarado and Samuel (pediatric appendicitis score [PAS]) appendicitis scoring systems in children and determine performance based on sex. METHODS: Children with abdominal pain concerning for appendicitis were recruited. Nine parameters evaluated by the scores were documented before imaging/surgery consultation. Test characteristics were calculated on all patients and by sex. RESULTS: Two hundred eighty-seven patients enrolled; median age was 9.8 years; and 155 (54%) were diagnosed with pathologic examination-confirmed appendicitis. Patients with appendicitis had mean PAS of 7.6, and those without had mean of 5.6 (P < .001). Patients with appendicitis had a mean Alvarado of 7.2, and those without had a mean of 5.2 (P < .001). In appendicitis patients, PAS cutoff of 6 or greater would give 137 correct diagnoses; sensitivity, 88%; specificity, 50%; and positive predictive value (PPV), 67%. An Alvarado cutoff of 7 or greater would give 118 correct diagnoses; sensitivity, 76%; specificity, 72%; and PPV, 76%. Both performed better in males than females. CONCLUSION: Regardless of sex, neither PAS nor Alvarado has adequate predictive values for sole use to diagnose appendicitis.
STUDY OBJECTIVE: The aims of the study were to prospectively evaluate the Alvarado and Samuel (pediatric appendicitis score [PAS]) appendicitis scoring systems in children and determine performance based on sex. METHODS:Children with abdominal pain concerning for appendicitis were recruited. Nine parameters evaluated by the scores were documented before imaging/surgery consultation. Test characteristics were calculated on all patients and by sex. RESULTS: Two hundred eighty-seven patients enrolled; median age was 9.8 years; and 155 (54%) were diagnosed with pathologic examination-confirmed appendicitis. Patients with appendicitis had mean PAS of 7.6, and those without had mean of 5.6 (P < .001). Patients with appendicitis had a mean Alvarado of 7.2, and those without had a mean of 5.2 (P < .001). In appendicitispatients, PAS cutoff of 6 or greater would give 137 correct diagnoses; sensitivity, 88%; specificity, 50%; and positive predictive value (PPV), 67%. An Alvarado cutoff of 7 or greater would give 118 correct diagnoses; sensitivity, 76%; specificity, 72%; and PPV, 76%. Both performed better in males than females. CONCLUSION: Regardless of sex, neither PAS nor Alvarado has adequate predictive values for sole use to diagnose appendicitis.
Authors: Anupam B Kharbanda; Nanette C Dudley; Lalit Bajaj; Michelle D Stevenson; Charles G Macias; Manoj K Mittal; Richard G Bachur; Jonathan E Bennett; Kelly Sinclair; Craig Huang; Peter S Dayan Journal: Arch Pediatr Adolesc Med Date: 2012-08
Authors: Ijab Khanafer; Dori-Ann Martin; Tatum P Mitra; Robin Eccles; Mary E Brindle; Alberto Nettel-Aguirre; Graham C Thompson Journal: BMC Pediatr Date: 2016-08-30 Impact factor: 2.125
Authors: Paul van Amstel; Ramon R Gorter; Johanna H van der Lee; Huib A Cense; Roel Bakx; Hugo A Heij Journal: J Gastrointest Surg Date: 2018-10-29 Impact factor: 3.452