title: Accuracies of diagnostic methods for acute appendicitis.
abstract: The objectives were to evaluate the effectiveness of ultrasonography, computed tomography, and physical examination for diagnosing acute appendicitis with analyzing their accuracies and negative appendectomy rates in a clinical rather than research setting. A total of 2763 subjects  were enrolled. Sensitivity, specificity, positive predictive value, and negative predictive value and negative appendectomy rate for ultrasonography, computed tomography, and physical examination were calculated. Confirmed positive acute appendicitis was defined based on pathologic findings,  and confirmed negative acute appendicitis was defined by pathologic findings as well as on clinical follow-up. Sensitivity, specificity, positive predictive value, and negative predictive value for ultrasonography were 99.1, 91.7, 96.5, and 97.7 per cent, respectively; for computed tomography,  96.4, 95.4, 95.6, and 96.3 per cent, respectively; and for physical examination, 99.0, 76.1, 88.1, and 97.6 per cent, respectively. The negative appendectomy rate was 5.8 per cent (5.2% in the ultrasonography group, 4.3% in the computed tomography group, and 12.2% in the physical examination  group). Ultrasonography/computed tomography should be performed routinely for diagnosis of acute appendicitis. However, in view of its advantages, ultrasonography should be performed first. Also, if the result of a physical examination is negative, imaging studies after physical examination  can be unnecessary.
authors: Department of Surgery, Myongji Hospital, Kwandong University, Goyang, Korea.
authors: Jong Seob
authors: JS
authors: Park
authors: Jin Ho
authors: JH
authors: Jeong
authors: Jong In
authors: JI
authors: Lee
authors: Jong Hoon
authors: JH
authors: Lee
authors: Jea Kun
authors: JK
authors: Park
authors: Hyoun Jong
authors: HJ
authors: Moon
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001062:Appendectomy; D001064:Appendicitis / Q000175:diagnosis* / Q000000981:diagnostic imaging / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D005188:False Negative Reactions; D005189:False Positive Reactions; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D010043:Outcome and Process Assessment, Health Care; D010808:Physical Examination; D011237:Predictive Value of Tests; D012189:Retrospective Studies; D012680:Sensitivity and Specificity; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography; D055815:Young Adult