Thursday, January 2, 2014

Using a Clinical Pathway to Predict Accurately a Suspected Appendicitis: A Prospective Study

In a quest to figure out the most accurate way to diagnose an acute appendix, Saucier et al. (doi: 10.1542/peds.2013-2208) designed a clinical pathway that used a known pediatric appendix score and an ultrasound study to classify patients as low-, middle-, and high-risk for appendicitis –with the low-risk being sent home in this prospective cohort, the middle- group getting an ultrasound, and the high-risk getting operated upon.

So how good is this new guideline? Good enough to carry a high sensitivity and specificity for accurate diagnosis of appendicitis. Just thinking that an ultrasound can be used in place of a CT scan to make this diagnosis is a concept that is certain to radiate positively within all of us.

Stay tuned-- tomorrow we continue our discussion on the appendix with a look at a study that uses white blood cell count to reduce the rate of negative appendectomies.

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