Estimating the probability of acute appendicitis using clinical criteria of a structured record sheet: the physician against the computer.
OBJECTIVE
To evaluate physicians' probability estimates of acute appendicitis based on structured collection of clinical data.


METHODS
Open prospective study.


METHODS
District hospital, Norway.


METHODS
304 patients admitted with suspected acute appendicitis.


METHODS
Initial diagnostic accuracy of physicians was compared with corresponding results from a computer model.


METHODS
The estimated probabilities of appendicitis in different testing groups were analysed using receiver operating characteristic (ROC) curves.


RESULTS
Physicians' estimates had a mean area under ROC-curve of 0.81 (95% CI 0.79 to 0.82), not significantly different from the computer model. Both correlated well with the actual rate of appendicitis, but the physicians tended to overestimate the probability by 10%.


CONCLUSIONS
Physicians' probability estimates perform rather well. Further attempts to implement a probabilistic approach in the diagnostic process of acute appendicitis therefore seem justified.
Hallan
S
S
Department of Clinical Chemistry, Innherred Hospital, Levanger, Norway.
Asberg
A
A
Edna
T H
TH
D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001064:Appendicitis / Q000175:diagnosis*; D002648:Child; D002675:Child, Preschool; D003661:Decision Support Techniques; D003936:Diagnosis, Computer-Assisted; D005260:Female; D006801:Humans; D016015:Logistic Models; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D012372:ROC Curve