title: Use of an appendicitis medical information sheet in the pediatric primary care system.
abstract: BACKGROUND
  Accurate and prompt diagnosis is required for the primary evaluation of pediatric appendicitis. Among pediatricians and surgeons working in Yamanashi Prefecture, the pediatric appendicitis medical information (PAMI) sheet was edited in April 2011 to reflect the diagnostic results of the pediatric primary and emergency medical service and used as a referral document for surgical consultation to secondary hospitals.
  
  
  METHODS
  The PAMI sheet consisted of sections for history taking, symptoms, physical signs and laboratory findings without a scoring system. For 32 consecutive months starting in April 2011, 59 patients hospitalized for suspected appendicitis were retrospectively reviewed. In particular, a total of 17 referral patients evaluated with the PAMI sheet were assessed in order to evaluate the utility of the form.
  
  
  RESULTS
  The pediatric surgeons were able to easily determine patient condition from the PAMI sheet. In total, 13 of 17 patients had appendicitis. According to the physical findings of the 17 studied patients, the judgment of right lower quadrant tenderness (κ = 0.63) and guarding (κ = 1.00) was consistent between the pediatric surgeons and primary attending pediatricians.
  
  
  CONCLUSIONS
  The PAMI sheet aids in the collection of detailed history and objective data with a high level of accuracy, and provides useful referral diagnostic information to the secondary-level hospitals.
authors.affiliation: Department of Pediatric Surgery, Yamanashi Prefectural Central Hospital, Yamanashi, Japan. oyachi-ampw@ych.pref.yamanashi.jp.
authors.forename: Noboru
authors.initials: N
authors.lastname: Oyachi
authors.affiliation: Department of Pediatrics, University of Yamanashi, School of Medicine, Yamanashi, Japan.
authors.forename: Hideaki
authors.initials: H
authors.lastname: Yagasaki
authors.affiliation: Department of Pediatric Surgery, Yamanashi Prefectural Central Hospital, Yamanashi, Japan.
authors.forename: Takeyuki
authors.initials: T
authors.lastname: Suzuki
authors.affiliation: Department of Pediatrics, University of Yamanashi, School of Medicine, Yamanashi, Japan.
authors.forename: Kosuke
authors.initials: K
authors.lastname: Higashida
authors.affiliation: Department of Pediatrics, Yamanashi Prefectural Central Hospital, Yamanashi, Japan.
authors.forename: Takayuki
authors.initials: T
authors.lastname: Komai
authors.affiliation: Department of Pediatric Surgery, University of Yamanashi, School of Medicine, Yamanashi, Japan.
authors.forename: Norio
authors.initials: N
authors.lastname: Hasuda
authors.affiliation: Department of Pediatric Surgery, University of Yamanashi, School of Medicine, Yamanashi, Japan.
authors.forename: Kunio
authors.initials: K
authors.lastname: Takano
authors.affiliation: Department of Pediatric Surgery, Yamanashi Prefectural Central Hospital, Yamanashi, Japan.
authors.forename: Kazuko
authors.initials: K
authors.lastname: Obana
mesh_terms: D000293:Adolescent; D001064:Appendicitis / Q000628:therapy*; D002648:Child; D002675:Child, Preschool; D019468:Disease Management; D004636:Emergency Service, Hospital; D005260:Female; D006801:Humans; D008297:Male; D008487:Medical History Taking; D008490:Medical Informatics / Q000295:instrumentation*; D011320:Primary Health Care / Q000379:methods*
keywords: appendicitis; diagnosis; medical information sheet; pediatrics; primary and emergency medicine