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J Korean Soc Emerg Med > Volume 24(1); 2013 > Article
Journal of The Korean Society of Emergency Medicine 2013;24(1): 39-45.
Prospective Evaluation of the Diagnostic Scoring Systems for Acute Appendicitis
Jeong Woon Kim, Sikyung Jeong, Woon Jeong Lee, Seung Pill Choi, Seon Hee Woo, Kyu Nam Park, Sung Youp Hong
Department of Emergency Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea. emhong@gmail.com
Scoring systems such as the Modified Alvarado Score (MAS), Eskelinen score (ES), Lintula score (LS), nd Ohmann score (OS) can be helpful in the early diagnosis of acute appendicitis (AA). We analyze and compare the diagnostic value of each scoring system and investigate the optimal cut off point.
A total of 62 adult patients admitted for suspicion of acute appendicitis in a tertiary hospital emergency department were analyzed prospectively. Each scoring system was calculated at admission and compared to the final diagnosis. Receiver operating characteristic (ROC) curves were used to determine the appropriate cutoff scores of scoring systems. The sensitivity and specificity, and area under the ROC curve were calculated.
The area under curve of the Ohmann score was higher than those of the other scoring systems (OS: 0.79, MAS: 0.73, ES: 0.65, LS: 0.67). In pairwise comparison of the ROC curve of two scoring systems, OS was found to have significantly higher predictive power than ES and LS. However, no difference was observed between MAS and OS.
No single score may be used alone to dictate or decline surgery. However, the scoring system may provide helpful information for primary or emergency physicians to determine whether the patient should undergo surgical consultation may provide helpful information for use by primary or emergency physicians in determination of whether the patient should undergo surgical consultation.
Key words: Appendicitis, Early diagnosis, ROC curve
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