title: Estimating the probability of acute appendicitis using clinical criteria of a structured record sheet: the physician against the computer.
abstract: 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.
authors.affiliation: Department of Clinical Chemistry, Innherred Hospital, Levanger, Norway.
authors.forename: S
authors.initials: S
authors.lastname: Hallan
authors.forename: A
authors.initials: A
authors.lastname: Asberg
authors.forename: T H
authors.initials: TH
authors.lastname: Edna
mesh_terms: 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