Evaluation of ultrasonography and clinical diagnostic scoring in suspected appendicitis

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Abstract
Background: Several diagnostic aids have been developed to improve diagnosis in suspected appendicitis including ultrasonography and clinical diagnostic scoring. The aim of this study was to elaborate a new scoring system and to measure its accuracy in the preoperative diagnosis of appendicitis, comparing it with the available scoring systems. Methods: The clinical, radiological and ultrasonographic data of 192 patients with suspected appendicitis were collected prospectively. Results: Only six of the 12 variables analysed were shown to have prognostic significance. Using Bayesian methodology, a weight was given to each criterion and two overall scores were calculated (ultrasonographic and classical scores). A cut-off point was identified to separate patients who needed surgery and those for observation. The ultrasonographic score showed an 81 per cent sensitivity and a 96 per cent specificity, compared with 60 and 73 per cent respectively for the classical score. Conclusion: Ultrasonography increases the diagnostic accuracy in patients with suspected acute appendicitis.