Background: Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods: A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results: Some 5345 patients across 154 UK hospitals were identified, of which two-thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut-off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut-off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion: Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision-making by identifying adults in the UK at low risk of appendicitis were identified.
Evaluation of appendicitis risk prediction models in adults with suspected appendicitis
Nepogodiev D; Matthews JH; Morley GL; Naumann DN; Ball A; Chauhan P; Bhanderi S; Mohamed I; Glasbey JC; Wilkin R; Drake TM; Clements J; Blencowe NS; Herrod P; Pata F; Frasson M; Blanco-Colino R; Soares AS; Bhangu A; Nepogodiev D; Bhangu A; Matthews JH; Morley GL; Bhanderi S; Ball A; Chauhan P; Jain S; Mohamed I; Amuthalingam T; Tyler R; Glasbey JC; Wilkin R; Pata F; Frasson M; Blanco-Colino R; Soares AS; Bhangu A; Nepogodiev D; Griffiths EA; Pinkney TD; Gee O; Morton DG; Beggs A; Beral D; Bhangu A; Blencowe NS; Bowley D; Cruickshank N; Daniels I; Griffiths E; Hornby ST; Lund JN; Marriott P; Pinkney TD; Singh P; Smart NJ; Speake D; Thompson C; Torkington J; Torrance A; Vohra R; Warren O; Wilkin R; Winter DC; Pata F; Pellino G ;Sgrò A; Simioni A; Farina V; Podda M; Di Saverio S; Birindelli A; Pasquali S; ITSurg; Soares AS; Surg PT; Blanco-Colino R; Frasson M; Blencowe NS; Bolton W; Bradshaw CJ; Chean CS; Harris G; Haddow JB; Jamieson NB; McCain S; Mason J; Milgrom D; Nana GR; Mohamed MN; Brien JO; Pearce J; Rabie M; Sahnan K; Sarmah P; Skerritt C; Ghazanfar MA; Sreedharan L; Kabwama S; Gray RT; Kamande IW; Nazarian S; Dar FA; Misky AT; Arunachalam S; Twum-Barima CS; Mohamed IM; Connor KL; Coe PO; Kosti A; Elshaer M; Colvin DA; Charalambous MP; Yeung K; Merker L; Morrison T; Thaventhiran AJ; Gilbert TM; Clements JM; Hicks G; Afshar S; Mckinley NC; Assaf N; Hanna T; Macinnes E; Thavanesan N; Dubois AS; Palani-Velu LK; Tezas S; Yow L; Radwan RW; Jamieson NB; Abdelrahman M; Lee KA; Zarka ZA; Mcdowall NA; Tan CY; Venn ML; Ashmore DL; Whitehorn SE; Golder AM; Reddy A; Delimpalta C; Kay OH; Sarmah P; Shah SM; Eiben I; Doyle C; Tudyka V; Issa E; West H; Brewer HK; Farrow EZ; Taylor NS; Smart CJ; Griffiths NP; Halkias C; Vitish-Sharma P; Knight SR; Mowbray NG; Olivier JB; Lee KJ; Clement KD; Chrastek D; Panda N; Connor MJ; Fahmy SE; Bryan ES; Ngu WS; Adegbola SO; Vaughan EM; Stupalkowska W; Simmonds L; Malik A; Hussein A; Karim MJ; Singhal T; Ormiston R; Nepogodiev D; Kung V; Rabie MA; Park JH; Lal N; Worku D; D'Auria M; Ang A; Orizu M; Gammeri E; Clough E; Choy CH; Herrod P; Lawday S; Hann AJ; Robinson D; Wardle BG; Mcdonnell D; Rutherford DG; Hickey LM; Garg AG; Rezvani S; Bell CR; Mahmood F; Rehman S; Donaldson G; Peleki A; Pearce L; Sharp OL; Jain S; Singh S; Thompson DB; El-Tayar O; Hollyman M; Rupasinghe SN; Toomey DB; Murray MP; Amtul N; Mersh RJ; Newton RC; Al-Khyatt W; Stephens GF; Abbas SH; Iqbal MR; Brown CE; Renshaw S; Hureibi KA; Pullabatla-Venkata UP; Donohoe NO; Myatt A; Egan RJ; Rangarajan K; Trail M; Mckay SC; Engall N; Jerome E; Townsend DC; Patel BY; Pronin S; Chandratreya N; Choong JH; Mohamed TM; Hudson-Peacock NJ; Manson R; Bhanderi S; Hebbar K; Mothe BS; Weegenaar CR; Saad M; Bowman CR; Serventi F; Fleres F; Foppa C; Pata G; Baronio G; Pertile D; Lucchi A; Sagnotta A; Maretto I; Campagnaro T; Gatti M; Gjoni E; Roscio F; Inama M; Coccolini F; Sgrò A; Colombo F; Avanzolini A; Aresu S; De-Manzoni-Garberini A; Merlini DA; Chessa A; Tamini N; Mulas S; Cillara N; Coletta D; Atzeni J; Erdas E; Gallo G; Francone E; Di Gioia P; Birindelli A; Bianchi CL; Ferrara F; Biancafarina A; Podda M; Scabini S; Marano L; Miegge A; Sasia D; Savino G; Pata F; Scatizzi M; D'Amico FE; Arcuri GA; Gavagna L; Salamone G; Tatulli F; Goldin E; Matos ML; Caldeira AB; Romano J; Pereira J; Azevedo J; Azevedo JM; Simoes J; Silva A; Soares AS; O'Leary DP; Kennedy ND; Quinn EM; Zhang AY; Neary PM; De-Marchi JA; O'Connor BR; Wijesundera K; Foley NM; Wong J; Kennedy ND; Tiedt LA; Bolger JC; Connelly TM; Ahmed OS; Vigorita V; García V; Arredondo J; Redondo E; Sainz B; Aldrey I; Landaluce-Olavarria A; Gómez AA; Cordoba E; Sánchez-Fuentes MN; Cerdán-Santacruz C; Beltran-De-Heredia J; García M; Veres T; García-Novoa A; Abellán AM; García-Catalá L; Ruiz-Marín M; Menendez P; Roldán-Ortiz S; Navas-Cuéllar JA; Sabia D; Gomez-Rosado JC; Navidad MS; Caula C; Sanchez ER; Espin-Basany E; Fernández-Martínez D; Bravo-Gutiérrez AF; Payá-Llorente C; Dujovne P; Lima F; Soria-Aledo V; Gomez CJ; Pascual-Miguelañez I; Muinelo M; Alvarez CM; Vargas-Pierola HJ; Vallve-Bernal M; Hidalgo-Rosas JM; Arenal-Vera JJ; Sena-Ruiz F; Sanchez-Guillen L; Villarejo-Campos P; Tallon-Aguilar L; Garcea A; Bennett JM; Whittaker L; Gidwani AL; Byrnes CK; Saunders S; Shiwani MH; Ashraf N; Venkatasubramaniam AK; Bevan KE; Mcarthur D; Mustafa AK; Griffith JP; Blazeby JM; Charalabopoulos A; Campbell W; Reese G; Warren OJ; Peacock M; Menzies D; Jenner D; Eardley NJ; Yoong S; Abulafi M; Avalapati H; Thompson R; Nastro P; Kochupapy R; Beral D; Stubbs BM; McIntyre R; Crozier J; Patel PK; Pento V; Beasley WD; Roxburgh C; Hornby ST; Youssef H; Alexander R; Denley S; Di Franco F; Quddus A; Saha A; Hunter I; Hannay J; Reddy A; Velchuru VR; Bond-Smith G; Salama Y; Bhargava A; Panagiotopoulos SP; Watson N; Tudyka V; Garcea G; Boddy AP; Dunning PG; Lloyd G; Gurjar SV; Smart CJ; Hill J; Andrews B; Singh A; Ruzvidzo F; Shingler G; Mahon D; Elgaddal S; Payne CJ; Shaikh IA; Dalmia S; Nair MS; Finch JG; Chapple KS; Bawa S; Watfah J; Carden CA; Makhija R; Rao M; Sarveswaran J; Vijay V; Rekhraj S; Singhal T; Knight B; Pinkney TD; Siddiqui MN; Sebastian JF; Glen P; Vakis S; Ebied H; Vohra R; Rajaram R; Gray J; Mcgrath D; Faulkner G; Gopalswamy S; Lund JN; Smart NJ; Varcada M; Woodward A; Williams GL; Szentpali K; Ravindran R; Bronder C; Thaha MA; Rate A; Shetty VD; Rao V; Sajid MS; Clements B; Patel RT; Mason C; Branagan G; Torrance A; Maude K; Kaur G; Lyons A; Ainsworth P; Hagger R; Zadi AZ; Maslekar SU; Kinross J; Irukulla S; Hawkins W; Wheatstone S; Magro T; Bailey S; Marshall G; Mccullough J; Marangoni G; Leung EL; Borg CM; Gopinath S; Torkington J; Kirkby-Bott J; Yalamarthi S; Mirza S; Brett M; Ramcharan S; Pandey V; Thava B; Speake D; Chandratreya N; Andreani SM; Sahay SJ; Aravind B; Downey M; Nicol D; Whitehouse P; Sharma A; Francis N; Chitsabesan P; Stewart DJ; Norcia GG; Cucinotta E; Cianchi F; Romario UF; Taglietti L; Capelli P; Garulli G; Parisi A; Nitti D; Guglielmi A; Alonzo A; Scandroglio IS; Roscio F; Moretto G; Ansaloni L; Pietrabissa A; Foschi D; Vettoretto N; Ercolani G; Coppola M; Colangelo E; Morandi E; Chessa A; Tamini N; Niolu P; Pala M; Coletti M; Pisanu A; Nicolosi A; Sammarco G; Berti S; Soliani P; Tonini V; Bianchi CL; Stella M; Ceccarelli G; De Nisco C; Scabini S; Castagnoli G; De Nardi P; Borghi F; Agresta F; Benevento A; Cantafio S; D'Amico FE; Cesari MC; Rubbini M; Salamone G; Chetta G; De Marchi F; Nora MF; Sousa HS; Nascimento CA; Casimiro C; Costa SD; Rosa MJ; Carvalho N; Correia J; Gomes AP; Hill AD; Walsh TN; Aremu MA; Mulsow J; El-Masry S; Gillick J; Garvin J; Caldwell M; Mehigan B; Winter DC; Peirce CB; Cooke F; Mealy K; Ruano A; Ais G; Fueyo J; Redondo E; Sainz B; Parajó AE; Landaluce-Olavarria A; Bernal-Sprekelsen JC; Cordoba E; Monzón-Abad JA; Cerdán-Santacruz C; Blanco F; Veres T; Abellán AM; Arroyo A; Ruiz-Marín M; Menendez P; Bazán-Hinojo MC; Navas-Cuéllar JA; Ramos-Bernado MI; Lopez-Ruiz JA; Golda T; Julià D; Cuadrado MM; Espin-Basany E; Fernández-Martínez D; Bravo-Gutiérrez AF; Gómez-Abril SA; Dujovne P; Martinez J; Aguayo JL; Millan M; Alvarez-Gallego M; Muinelo-Lorenzo M; Parra JM; Muñoz-Muñoz E; De Chaves-Rodríguez PG; Cánovas-Moreno G; Rodriguez-Lopez M; Segura-Sampedro JJ; García-Granero A; Redondo-Calvo FJ; Tallon-Aguilar L; Garcea A; Dyson S; Thakur D; Sreedharan L; Swords C; Siaw O; Zelazek M; Woo R; Badran A; Aruparayil N; Christopoulos P; Chambers B; O'Neill N; Long RH; Gray RT; Mccaughey P; Wong ML; Mccain RS; Lennox-Warburton HC; Moore C; Manektella KM; Kamande IW; Mcilwaine S; Rupani S; Simpson DJ; Wauchope J; Ng M; Christian L; Crone A; Haddow JB; Sacks R; Nazarian S; Symons N; Lazzaro A; Patil SD; Dar FA; Roomi S; Silva I; Hodgson JM; Ly C; Misky AT; Froud H; Patel H; Arunachalam S; Cay P; Karwal RS; Arunachalam S; Danquah-Boateng D; Berry B; Esmail HD; Twum-Barima CS; Maripi H; Bilku D; McKelvie MA; Miller K; Maina A; Velho R; Hasan R; Clingan R; Jah S; Waite K; Jones A; Buckley-Jones S; Lecky-Thompson L; Connor KL; Saghir N; Mansoor S; Mistry D; Brown R; Wong A; Gurung S; Wensley F; Fleming TA; Griggs R; Kosti A; Haines S; Bedoya S; Beverstock A; Johnson J; Elshaer M; Govind G; Niaz O; Colvin DA; Dyal A; Tokidis E; Punj S; Leusink A; Yeung K; Rudland I; Kelly M; Morgan R; Al-Musawi S; Lek C; Gilbert A; Gosal A; Mahoney R; Parwaiz I; Morrison T; Mitchard MJ; Ribeiro B; Merai H; Dean EA; Khan S; Baginski A; Mann C; Foers W; Jones L; Woodward B; Mcwhirter DM; Thomas AT; Gilbert TG; Weatherburn LW; Pilkington JP; Cameron FC; Gilbert TM; Chean CS; Clements JM; Clements JD; Mccann C; Davidson S; Hackney L; Clements JS; Martin A; Hicks G; Du DT; Shakoor Z; Yen SK; Adnan M; Ranathunga S; Sana S; Tay YH; Chin MY; Gillespie M; Brown AG; Campbell U; Assaf N; Chatzikonstantinou M; Mahendran B; Flack T; Chowdhary M; Lim JM; Macinnes E; Whiteman E; Shepherd JA; Pedder A; Thavanesan N; Siggens KL; Lai CW; Morrison-Jones V; Hayat Z; Dubois AS; Nehikhare I; Macleod C; Quinn HC; Brown A; Neagle G; Palani-Velu LK; Chok SM; Carrano FM; Abbassi OA; Divekar GA; Halmer S; Yow L; Pento V; Adams RE; Davies PL; Wong SY; Amarasinghe R; Tague LE; Jones E; Radwan RW; Martin A; Jones E; Jamieson NB; Singh J; Boza K; Kelly SD; Morrison F; Chan WH; Blencowe NS; Abdelrahman M; Wilson EJ; Awokoya OO; Griffiths SN; Kirkham EN; Cotton AE; Adimonye A; Leighton PA; Lee KA; Abdelrahman A; Cartwright H; Gates Z; Miguras M; Zarka ZA; Khan K; Louw C; Grove T; Badenoch T; Mckeon J; Mcdowall NA; Wood CS; Leitch RP; Sgardelis P; Perera MI; Nagarajan D; Malam Y; Theodoropoulou K; Venn ML; Rajagopal S; Kaptanis S; Popova D; Olagbaiye O; Tayeh S; Rigby S; Ashmore DL; Harris MP; Whitehorn SE; Ren KZ; Liaw G; Zhou S; White F; Golder AM; Marshall CM; Mitchell JH; Anderson DJ; Kanakala V; Hollingsworth A; Paramasevon KR; Milward J; Ahmed S; Delimpalta C; Fanibi BF; Ferguson N; Dickson EA; Shaw AV; Kay OH; Dixon F; Morrish S; Dandy R; Fooks P; Sharma P; Islam N; Tabain V; Keegan R; Sarmah P; Ahel J; Alhammali T; Graveston J; Balai EJ; Graveston J; Shah SM; Rothnie K; Pankin GP; Eiben IE; Jackson NJ; Dhar M; Nash D; Doyle C; Dharamavaram S; Seth M; Chowdhury F; Rezacova M; Seneviratne N; Turner EJ; Currow C; Issa E; Isherwood JD; Hobson BM; West H; Lui DH; Nana GR; Rodger V; Ting N; Brewer HK; Photiou D; Farrow EZ; Taze D; Lodhia S; Earnshaw L; Kumar K; Neale A; Bastianpillai J; Cipparrone M; Barrie A; Taylor NS; Nash Z; Anandan L; Tailor K; Vinnicombe Z; Krivan S; Kuo R; Giorga A; Habib H; Malik K; Bogdan M; Mahon-Daly FP; Athersmith MJ; Strange JA; Griffiths NP; Wheeler C; Summerfield L; Khaw RA; Ashour O; Iosif E; Fadel M; Gopalakrishnan K; Orme N; Williams S; Rashid M; Sultana A; Patel N; Knight SR; Pearson R; Yasin T; Bevan V; Mowbray NG; Al-Sarireh B; Olivier JB; Brown M; Mohd N; Howie EE; Poudevigne M; Paget C; Rallage H; Chui K; Fawzi F; Layman S; Okorocha E; Jama GM; Orawiec P; Kouli O; Hassane A; Clement KD; Kilkenny J; Devine AA; Laurenson M; Slezak I; Barker T; Lau E; Limbada M; O'Brien J; Weaver J; Barker T; Panda N; Hajibandeh S; Shah J; Mansour MM; Malik SN; Davis S; Trew F; Bandyopadhyay SK; Dart K; Connor MJ; Guru-Naidu S; Callan R; Nair MK; Alani M; Sezen E; Salim S; Fahmy SE; Shurlock J; Siddique K; Forouzanfar A; Brews R; Ngu WS; Acharya A; Jain A; Adegbola SO; Sahnan K; Tozer PJ; Warusavitarne J; Emslie KM; Collier-Wakefield O; Sivaloganathan P; Dobson C; Elseedawy M; Vaughan EM; Stupalkowska W; McNally L; Williams M; Motiwala FH; Choi S; Asmadi AA; Burnside D; Everden A; Suriyakumar S; Sandu L; Kent DA; Bowen J; Simmonds L; Long P; Khair A; Malik A; Shah K; Phelan L; Pierre R; Dhari AA; Hussein A; Hoff M; Karim MJ; Nickson S; Setshwaelo T; Chalk A; Parkola MJ; Harlinska A; Chan T; Dudek JG; Rolph R; Allen M; Pollard H; Ormiston R; Gormely R; Finlayson H; Ljungqvist G; Peponis C; Glasbey JC; Tyler R; Rahman M; Dhesi S; Mohamed MN; Arshad F; Wilkin R; Faris AR; Sooriyamoorthy T; Kung V; Springate EL; Barnieh W; Patel AS; Siddiqui ZA; Chishti IA; Ayube-Brown J; Rabie MR; Blake L; Yardimci E; Nagendram S; Park JH; Neophytou GI; Henderson L; Farhan-Alanie M; Kong CY; Ghazala R; Lal N; Evans J; Hussain N; Kabir M; Worku D; Hraishawi I; D'Auria M; Cox M; Bailey JA; Muhibullah N; Yanni F; Ang A; Orizu M; Stevenson R; Nair A; Murphy C; Mcgucken O; Gammeri E; Pandya R; Bowerman H; Lafaurie G; Van Boxel GI; Shanmugarajah K; Maragouthakis D; Hanif Z; Evans JD; Yoganathan S; Richardson TD; Choy CH; Cook V; Clark GL; Rigney B; O'Neill E; Guliani J; Herrod P; Chan D; Harper F; Sian T; Boereboom C; Blackwell J; Hardy E; Boyd-Carson H; Couch DG; Barter CA; Thoukididou SN; Hatt JR; Jones CS; Dean S; Rajaretnam N; Lawday S; Masood M; Thakral N; Griffith D; Doherty C; Longshaw A; Peprah D; Mathew G; Hann AJ; Hook A; Robinson D; Vance-Daniel J; Ibrahim Y; Wardle BG; Walters KJ; Whewell HE; Sherif MA; Mckenna M; Pearce J; O'Sullivan D; Woodrow C; Gill S; Johnstone A; Gentry R; Irwin R; Forgie A; Welsh S; Hickey LM; Ivey P; Bullivant JK; English WJ; Osterberg A; Morowala A; Al-Faham Z; Islam S; Tan E; Garg AG; Sadek S; Sihra N; Shrestha D; Chong B; Nadeem A; Fasuyi JA; Patel MM; Daureeawoo R; Okekunle B; Cheruvu M; Mazumdar E; Mahmood F; Hussain A; Patel C; Mcquaid M; Banks A; Robinson A; Khan MS; Riaz W; Verroiotou M; Cohen JA; Kouroumpas E; Rehman S; Donaldson G; Ghaffari I; Moradzadeh J; Peleki A; Kamal M; Gulamhussein M; Pearce L; Gaines E; Ghatorae S; Clark S; Sharp OL; Savill A; Hutchinson B; Chapman J; Wu F; Creasy W; Raymond M; Grosvenor S; Odeh A; Malik Y; Bansal H; Grant C; Raofi A; Ahmed B; Mai D; Thompson DB; Souter J; Hamelmann RN; Ikram S; El-Tayar O; De-Manzoni-Garberini A; Hollyman M; Durbacz M; Gilliland N; Salem A; Chudek D; Rupasinghe SN; Ladwa N; Storey R; Fontaine C; Toomey D; Miller B; Robinson A; Oakey M; Smoker H; Amtul N; Chapman SJ; O'Hagan SC; Tahir W; Wilcox G; Ahmad A; Akram F; Baddams TS; Boshier PR; Fehervari M; Easdon S; Mersh RJ; Ilozue T; Adam ME; Newton RC; Jokhan S; Foster A; Nambiar K; Bohra P; Janardanan S; Shanmuganathan V; Maqboul F; Ettles C; Wardle SD; Martinou E; Stephens GF; Khasria A; Bagga R; Motter D; Mundkur N; Pan Y; Abbas SH; Akbari K; Farrell SM; Rahim A; Gummaraju A; Iqbal MR; Mahmoud A; Akinsola O; Smallcombe N; Tarazi M; Hanley C; Brown CE; Campbell UM; Mckinley NC; Renshaw S; Franklin D; Davidson JR; Hureibi KA; Raza SS; Krishnamoorthy A; Rajjoub Y; Ali M; Seddon TC; Payne RE; Das A; Martin LM; Naismith KN; Venkata UP; Manda VM; Donohoe NO; Burns KM; Huang J; Samuel M; Docherty JA; Cheah WL; Ooi R; Nyeko-Lacek M; Marsh L; Prideaux A; Li CH; Poacher A; Lee M; Muzaffar M; Egan RJ; Kara A; Walsh E; Kara A; Sunter H; Roth N; Roy C; Mcmorran D; Turnbull A; Trail M; Layton GR; Archer JE; Yang P; Engall N; Henderson L; Douka E; Amin V; Borghol K; Marriott P; Townsend DC; Blackford OD; Bond S; Baker B; Mohamed WO; Williams R; Garnham J; Patel BY; Robb HD; Allington J; Cloney L; Tamborska A; Kalia K; Fung E; Johnston Z; Lynch L; Christides A; Tan HL; Cynthia G; Tsang B; Rossi C; Kaubrys M; Al-Khafaji N; Jenkins M; Choong JH; Chok SM; Peiris GB; Mohamed TM; Gunning S; Nimako E; Pandya D; Hever P; Amayo A; Bull C; Hudson-Peacock NJ; Clements C; Al-Sheikh M; Savioli F; Long M; Horsfield E; Robertson C; Ogboru S; Mcilwrath AC; Bhanderi S; Bailey S; Bell J; Hebbar K; Limb C; Obeid N; Rich JE; Balasubramaniam A; Mothe BS; Mashar R; Taylor M; Bruce JS; Weegenaar CR; Dennison G; Curtis NJ; Saad M; Ezerska E; Ellis B; Brown M; Wiggill S; Tee A; Ng S; Carder C; Abdelwahed A; Bowman CR; Chandler SB; Tinsley BJ; Savino G; Finotti E; Serventi F; Occhioni G; Cossu F; Vulcano I; Viscosi F; Pata G; Baronio G; Michelini M; Compagnoni B; Sepe C; Isolani SM; Regina G; Pertile D; Lucchi A; Alagna V; Martorelli G; Gabbianelli C; Moroni P; Zuin M; Conci S; Campagnaro T; Lazzari G; Costamagna D; Choong JH; Zurleni TZ; Altomare MA; Gjoni E; Desiderio J; Sagnotta A; Di Cintio A; Gemini A; Trastulli S; Carrano FM; Brown CE; Viviani E; Inama M; Coccolini F; Tomasoni M; Montori G; Sgrò A; Harder G; Argenti F; Malabarba S; Checcacci P; Montanelli P; Guerra F; Skalamera I; Staderini F; Grandi S; Nelli T; Coratti F; Sorrentino L; Maffioli A; Colombo F; Cavallo D; Bondurri A; Groppo G; Curti R; Solaini L; Xidas A; Aresu S; Manias T; Delogu D; Vacca A; Solinas L; De-Manzoni-Garberini A; Corbellini C; Fiore L; Nigro A; Santurro L; Angrisani M; Tamini N; Mulas S; Sparta C; Lorettu A; Mura FA; Ruggiu GV; Pirari PF; Pau R; Melis M; Piu F; Patti S; Deserra A; Cillara N; Coletta D; Angelieri D; Del Basso C; Rossi D; Iannone I; De Padua C; Giubilo C; Falaschi F; Cirillo B; Gordini L; Podda F; Sanna S; Erdas E; Saba A; Poillucci G; Pinna E; Messina A; Sena G; Sammarco G; Cardona R; Gallo G; De Luca E; Sacco R; Vescio G; Ammendola M; Romano R; Bianco A; Bonfante P; D'Ambra L; Feleppa C; Francone E; Gennai A; Lizzi V; Moggia E; Imperatore M; Bolzon S; Assaf N; Chatzikonstantinou M; Birindelli A; Belvedere A; Amaducci E; Ripoli MC; Segalini E; Cervellera M; Vaccari S; Eretta CO; O'Neill R; Llewelyn O; Engall N; Jones N; Clerici F; Ballabio M; Ferrara F; Andolfi E; Angelini M; Biancafarina A; Fontani A; Miranda E; Scricciolo M; Provenza G; Pellicanò GA; Pulighe F; Podda M; Argenio G; Melis A; Balestra F; Anania M; Cruccu A; Massaiu C; Murru ML; Martino A; Luzzi AP; La Valle G; Scabini S; Chillitupa CZ; Bartoli A; Conti D; Marano L; Spaziani A; Bellochi R; Listorti C; Castagnoli G; Salandini MC; Miegge A; De Nardi P; Carlucci M; Pata F; Tenconi SM; Cannavò M; Sasia D; Marano A; Giuffrida MC; Cannata G; Pellegrino L; Giraudo G; Baraghini M; Garzi A; Giudicissi R; Zalla T; Romoli L; Vannucchi A; Giani I; Feroci F; Calussi M; Ribaudo M; Fiorot A; Stecca T; D'Amico FE; Nistri C; Fornasier C; Arcuri GA; Valiani SV; Brunelli DB; Evoli LE; Giuliani NG; Contine AC; Renzi CR; Feo CV; Anania G; Gavagna L; Carcoforo P; Aisoni F; Salamone G; Licari L; Tutino R; Cocorullo G; Silvestri V; De Marco P; Fontana T; Orlando G; Falco N; Baseggio M; Napetti S; Mella A; Rossi GM; Chimetto A; Goldin E; Cosci M; Bonomo M; Scialandrone G; Chetta N; Matos ML; Carvalho LC; Magalhães JS; Pereira AM; Fernandes C; Fareleira A; Gonçalves D; Pais M; Pereira A; Resende FM; Correia D; Cardoso D; Tojal A; Santos SC; Barbosa L; Louro HC; Bairos F; Martins FM; Messias FM; Ferreira MS; Borges FC; Botelho P; Lima M; Valente PM; João AA; Guimarães JM; Soares AS; Rocha R; Nogueira ST; Kabir U; Wong C; Rahmani LS; Tan S; Chng S; Jasinski B; Cheng SA; Mardhiah S; McGlynn K; Hannan E; Burke J; Kennedy ND; Haveliwala Z; O'Neill M; Boland M; Hayes C; Fox A; Zaborowski A; Mitru RM; De-Marchi JA; Mc-Dermott A; Coyle D; Stoica I; McMahon SV; O'Connor BR; Laughlin DM; Kannegieser-Bailey M; Murphy R; Muntean A; Shet S; Thomas L; De Freitas S; Quill S; Aljorfi A; Foley NM; Soh B; Law JJ; Hartnett J; Jansen T; Gilgan J; Jung J; Scanlon K; Szucs A; Wong J; Ahern DP; Redmond AE; Szucs A; Edwards SE; Tiedt LA; Manoharan P; Brennan S; Bolger JC; Abdelgadir AM; Mckevitt KL; Zarog MA; Ahmed G; Bukhari W; Ahad A; Ahmed OS; Paniagua M; Samartin C; Primo JC; Garrido L; Lopez M; Rufo E; Trostchansky I; Rodriguez L; Infante H; Acosta A; Cremades P; Cidoncha A; Olmos V; Oliva I; Santamaria C; Cavero A; Calvo H; Suero CA; Maderuelo VM; Galvez P; Hernando A; Eguaras I; Recreo AC; García-Carrero M; Moreda R; García M; De Andres U; Del Pozo E; Calvo M; Moratalla CN; Ronda RN; Contreras RG; De Burgos CB; Cortés GV; Martínez CC; Agudo AR; Soriano JT; Ramos XH; Echazarreta E; Elia M; Hernaez A; Sanchez L; Vallejo-Bernad C; Oliver JR; Sánchez-Rubio M; Kälviäinen HK; Genzor S; González-Nicolás T; Puerta E; Laviano E; Gimenez T; Cerdán-Santacruz C; Fermiñán A; Muriel-Álvarez P; Sierra-Grañón JE; Escoll-Rufino J; Cuello-Guzmán E; Mestres-Petit N; Merichal-Resina M; Pinillos-Somalo A; Gomez-Carmona Z; Vazquez-Fernandez AP; Trujillo-Diaz JJ; Couso JR; Fernández MD; Riera E; Espinosa J; García-Novoa A; Carral-Freire M; Martínez-Almeida R; Santarrufina-Martínez S; Sebastián-Tomás JC; Gonzálvez-Guardiola P; Fernández EC; Mozo AS; Stoyanov TI; Santamaría PC; Grimaldo EG; García-Catalá L; Fernández-Candela A; Curtis-Martínez C; Del-Valle-Ruiz SR; Sánchez-Cifuentes A; Ramírez-Faraco M; López AF; Leon C; Kumar S; Fornell-Ariza M; Ayllón-Gámez S; Peña-Barturen C; Ojea-Ruiz-Yherla L; Saavedra-Chacón M; Navas-Cuéllar JA; Perez-Calvo J; Gomez-Facundo H; Riba-Combatti L; Manas OC; De-Soto-Cardenal B; De-La-Herranz-Guerrero P; Dominguez-Sanchez C; Gamero-Huaman JC; Suarez-Cabrera A; Ramirez-Redondo AA; Lara-Fernandez Y; Bascuas-Rodrigo B; Lopez-Duran BL; Caula C; Pigem A; Gil J; Salvador H; Planellas P; Farrés R; Sanchez ER; Caballero A; Arnau M; Blanco-Colino R; Tapiolas I; Ridaura N; Roncero LS; Collado-Roura F; Fijo LM; Navidad MS; Cormenzana OB; Viñas NL; Grifell MS; Prats MA; Torrado AA; Sanz-Navarro S; Contreras-Saiz E; Solar-García L; Moreno-Gijón M; Suárez-Sánchez A; Díaz-Vico T; Fernández-Martínez D; Rodicio-Miravalles JL; García-Gutierrez C; Pila U; Melone S; Martin-Prieto L; Rojo JA; Gonzalez M; Zorrilla L; Soria-Aledo V; Garcia-Marin JA; Baeza-Murcia M; Pellicer-Franco E; Jimenez-Ballester MA; Asensio-Gomez L; Gortazar-De-Las-Casas S; Guevara-Martinez J; Lopez M; Ramirez L; Verea S; Anguita F; Navarro G; Criado ADC; Lara MC; Martinez ET; Sanchez-Martinez A; Hernandez-Gimenez L; Galofre-Recasens M; Ferrer-Vilela I; Pérez-Sanchez LE; Esteves MB; Menéndez-Moreno A; Baz-Figueroa C; Rosat A; Hontoria MS; García NA; Gracia-Roman R; Pascua-Sole M; Pino-Perez O; García-Pérez JM; Pineño-Flores C; Ambrona-Zafra D; Sanchez-Guillen L; Sancho-Muriel J; Alvarez E; García-Granero A; Jiménez-Rosellón R; Daga O; Alberca-Paramo A; Sanchez-Garcia S; García-Santos E; Pareja-Ciuró F; Olivares-Oliver C; Navarro-Morales L; Tamayo-López MJ; Tinoco-González J; García-Rivera CO; Agua IA; Moreno-Suero F; Pereira-Mosquera E; Zerpa C; Llacer E; Diaz A; Caro A; Feliu F; Franco M; Escuder J; Abellan M; Padilla E; Rodriguez-Lopez M; Mambrilla-Herrero S; Plua-Muniz KT; Bailon-Cuadrado M; Tejero-Pintor FJ; Choolani-Bhojwani E; Vila-Zarate C; Delgado-Plasencia LJ; Ponchietti L; Pata G; Cousins L; Busuttil A; Baird C; Drye N; Brown OD; Mansour S; Anderson O; Woodward B; Mahapatra R; Clements JA; D'Souza N; Thompson R; Littlehales DJ; Tang AM; Byrne BE; Tan CY; Cunha P; Ogbuokiri C; Alhammali T; Eiben P; Chowdhury F; Gravante G; Kho H; Lodhia S; Dobbs S; Doulias T; Ng J; Wilson M; Venugopal R; Panda N; Wolff J; Akhtar K; Walji HD; Tognarelli JM; Knight KA; Ansari A; Hussaini SA; Wright E; Gammeri E; Brewer H; Rinkoff S; Harries RL; Fairfield CJ; Hickey LM; Abbott T; Jackson A; Wright HL; Walters U; Carney K; Logan PC; Mughal Z; Strachan E; Boland M; Andreani SM; Chasty B; Sharma A; Ma J; Mazzeo C; Badii B; Armellini A; Grassia M; Perin A; Ruzzenente A; Roscio F; Magnoli M; Avanzolini A; Mulas S; Cillara N; Depalma N; Longheu A; Papandrea M; Dova L; De Prizio M; Gusai GP; Di Zitti L; Geretto P; Azabdaftari A; Chianese G; Elbetti C; Ruffolo C; Giaccari S; Salamone G; Devezas V; Ferreira JS; Peixoto R; Hill AD; Alshafei A; Ais G; Simo V; José HS; Ugarte-Sierra B; Gómez AA; Cerdán-Santacruz C; Beltran-De-Heredia J; Bazán-Hinojo MC; Navas-Cuéllar JA; Gomez-Rosado JC; Salva AB; Gómez N; Marinello F; Medina-Arana V; Payá-Llorente C; Vega L; Ballester MM; Espina B; Prieto-Nieto MI; Lopez M; Rodríguez EC; Rodriguez-Lopez M; Frasson M; Padilla-Valverde D; Duran-Muñoz-Cruzado VM.
2020
Abstract
Background: Appendicitis is the most common general surgical emergency worldwide, but its diagnosis remains challenging. The aim of this study was to determine whether existing risk prediction models can reliably identify patients presenting to hospital in the UK with acute right iliac fossa (RIF) pain who are at low risk of appendicitis. Methods: A systematic search was completed to identify all existing appendicitis risk prediction models. Models were validated using UK data from an international prospective cohort study that captured consecutive patients aged 16–45 years presenting to hospital with acute RIF in March to June 2017. The main outcome was best achievable model specificity (proportion of patients who did not have appendicitis correctly classified as low risk) whilst maintaining a failure rate below 5 per cent (proportion of patients identified as low risk who actually had appendicitis). Results: Some 5345 patients across 154 UK hospitals were identified, of which two-thirds (3613 of 5345, 67·6 per cent) were women. Women were more than twice as likely to undergo surgery with removal of a histologically normal appendix (272 of 964, 28·2 per cent) than men (120 of 993, 12·1 per cent) (relative risk 2·33, 95 per cent c.i. 1·92 to 2·84; P < 0·001). Of 15 validated risk prediction models, the Adult Appendicitis Score performed best (cut-off score 8 or less, specificity 63·1 per cent, failure rate 3·7 per cent). The Appendicitis Inflammatory Response Score performed best for men (cut-off score 2 or less, specificity 24·7 per cent, failure rate 2·4 per cent). Conclusion: Women in the UK had a disproportionate risk of admission without surgical intervention and had high rates of normal appendicectomy. Risk prediction models to support shared decision-making by identifying adults in the UK at low risk of appendicitis were identified.
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Il report seguente simula gli indicatori relativi alla propria produzione scientifica in relazione alle soglie ASN 2023-2025 del proprio SC/SSD. Si ricorda che il superamento dei valori soglia (almeno 2 su 3) è requisito necessario ma non sufficiente al conseguimento dell'abilitazione. La simulazione si basa sui dati IRIS e sugli indicatori bibliometrici alla data indicata e non tiene conto di eventuali periodi di congedo obbligatorio, che in sede di domanda ASN danno diritto a incrementi percentuali dei valori. La simulazione può differire dall'esito di un’eventuale domanda ASN sia per errori di catalogazione e/o dati mancanti in IRIS, sia per la variabilità dei dati bibliometrici nel tempo. Si consideri che Anvur calcola i valori degli indicatori all'ultima data utile per la presentazione delle domande. La presente simulazione è stata realizzata sulla base delle specifiche raccolte sul tavolo ER del Focus Group IRIS coordinato dall’Università di Modena e Reggio Emilia e delle regole riportate nel DM 589/2018 e allegata Tabella A. Cineca, l’Università di Modena e Reggio Emilia e il Focus Group IRIS non si assumono alcuna responsabilità in merito all’uso che il diretto interessato o terzi faranno della simulazione. Si specifica inoltre che la simulazione contiene calcoli effettuati con dati e algoritmi di pubblico dominio e deve quindi essere considerata come un mero ausilio al calcolo svolgibile manualmente o con strumenti equivalenti.