Combined clinical and ultrasound assessment enhance appendicitis diagnostic accuracy

摘要

Commentary The diagnosis of acute appendicitis remains elusive, with high rates of perforation. Clinical scoring systems and US, when evaluated independently, have low to moderate sensitivity. This study adds to the existing literature supporting integration of the PAS with US, to enhance diagnostic accuracy.2'3 The PAS, when considered independently, correlated with the likelihood of appendicitis. However, among the high-risk group (PAS 7-10), the false negative rate was 19%; within the low risk group (PAS 0-3), 27% of US results were false positive. When US results were discordant with clinical suspicion, the authors recommended serial examination or further imaging. Notable limitations include: (1) enrollment bias; (2) requirement of an advanced imaging study or surgical consultation to be eligible; (3) PAS was calculated retrospectively and could not be ascertained in 16.4% of patients; and (4) results are not generalizable to the community hospital setting.