Diagnosis of appendicitis in adults by ultrasonography or computed tomography: a systematic review and meta-analysis.
OBJECTIVE
The use of ultrasonography and computed tomography (CT) in the diagnosis of appendicitis in adult patients was compared.


METHODS
Systematic review and meta-analysis of current evidence in two clinical situations: unselected nonpregnant, adult patients with symptoms of appendicitis, and more selective use in only those patients who still have an equivocal diagnosis subsequent to routine clinical investigations.


RESULTS
Meta-analysis of eligible studies shows CT to have better sensitivity and specificity than ultrasound in both clinical situations.


CONCLUSIONS
Application of these findings in clinical practice and/or policy would need to evaluate the better diagnostic performance of CT against its cost and availability. In addition, it is imperative that future studies be conducted in patient populations that are well-defined with respect to prior investigations. Sequelae of false-negative and false-positive diagnoses should also be evaluated.
Weston
Adèle R
AR
Health Technology Analysts Pty Ltd., Balmain, New South Wales, Australia. aweston@htanalysts.com
Jackson
Terri J
TJ
Blamey
Stephen
S
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001064:Appendicitis / Q000175:diagnosis / Q000000981:diagnostic imaging; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D012680:Sensitivity and Specificity; D036542:Tomography, Spiral Computed; D014463:Ultrasonography