EVIDENCE-BASED MENTAL HEALTH
Review: symptoms, signs, and lab tests have moderate accuracy for detecting appendicitis in children
| The first 150 words of the full text of this article appear below. |
REVIEW PROCESS
how accurate are symptoms, signs, and laboratory tests for diagnosing appendicitis in children with abdominal pain?
Medline (to March 2007), Cochrane Library, textbooks, and reference lists.
fully published studies in English that evaluated the accuracy of medical history, physical examination, or basic laboratory tests for diagnosing appendicitis in children, using independent, blinded comparison with a gold standard—surgical pathological findings, clinical observation, or follow-up (level of evidence 1–3). 25 studies were included: 1 level 1 study (n = 246) of unselected children presenting to the emergency department with undifferentiated abdominal pain (appendicitis prevalence 10%) and 24 level 3 studies (n = 5590) of selected patients with suspected appendicitis (appendicitis prevalence 25–89%).
sensitivity, specificity, and positive and negative likelihood ratios (LRs).
MAIN RESULTS
The table shows the results.
CONCLUSION
The most useful single feature for diagnosing appendicitis in children with abdominal pain was fever in unselected children and rebound tenderness in selected children.
ABSTRACTED FROM
Bundy
Columbia University, New York City, New York, USA
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