Optimising diagnostics to discriminate complicated from uncomplicated appendicitis: a prospective cohort study protocol
| Autor: | Wouter J Bom, Jochem C G Scheijmans, Sander Ubels, Anna A W van Geloven, Sarah L Gans, Kristien M A J Tytgat, Charles C van Rossem, Lianne Koens, Jaap Stoker, Willem A Bemelman, Marcel G W Dijkgraaf, Marja A Boermeester |
|---|---|
| Přispěvatelé: | Graduate School, Surgery, AII - Infectious diseases, AGEM - Amsterdam Gastroenterology Endocrinology Metabolism, Gastroenterology and Hepatology, APH - Quality of Care, APH - Societal Participation & Health, CCA -Cancer Center Amsterdam, Pathology, Radiology and Nuclear Medicine, Epidemiology and Data Science, APH - Methodology |
| Rok vydání: | 2022 |
| Předmět: |
Adult
gastroenterology General Medicine Appendicitis Cohort Studies surgery Observational Studies as Topic Tumours of the digestive tract Radboud Institute for Health Sciences [Radboudumc 14] All institutes and research themes of the Radboud University Medical Center Predictive Value of Tests Acute Disease Humans colorectal surgery radiology & imaging Prospective Studies |
| Zdroj: | BMJ Open, 12 BMJ open, 12(4):e054304. BMJ Publishing Group BMJ Open, 12(4):e054304. BMJ Publishing Group BMJ Open, 12, 4 Bom, W J, Scheijmans, J C G, Ubels, S, van Geloven, A A W, Gans, S L, Tytgat, K M A J, van Rossem, C C, Koens, L, Stoker, J, Bemelman, W A, Dijkgraaf, M G W & Boermeester, M A 2022, ' Optimising diagnostics to discriminate complicated from uncomplicated appendicitis : a prospective cohort study protocol ', BMJ Open, vol. 12, no. 4, e054304, pp. e054304 . https://doi.org/10.1136/bmjopen-2021-054304 |
| ISSN: | 2044-6055 |
| Popis: | IntroductionGrowing evidence is showing that complicated and uncomplicated appendicitis are two different entities that may be treated differently. A correct diagnosis of the type of appendicitis is therefore essential. The Scoring system of Appendicitis Severity (SAS) combines clinical, laboratory and imaging findings. The SAS rules out complicated appendicitis in 95% (negative predictive value, NPV) and detects 95% (sensitivity) of patients with complicated appendicitis in adults suspected of acute appendicitis. However, this scoring system has not yet been validated externally. In this study, we aim to provide a prospective external validation of the SAS in a new cohort of patients with clinical suspicion of appendicitis. We will optimise the score when necessary.Methods and analysisThe SAS will be validated in 795 consecutive adult patients diagnosed with acute appendicitis confirmed by imaging. Data will be collected prospectively in multiple centres. The predicted diagnosis based on the SAS score will be compared with the combined surgical and histological diagnosis. Diagnostic accuracy for ruling out complicated appendicitis will be calculated. If the SAS does not reach a sensitivity and NPV of 95% in its present form, the score will be optimised. After optimisation, a second external validation will be performed in a new group of 328 patients. Furthermore, the diagnostic accuracy of the clinical perspective of the treating physician for differentiation between uncomplicated and complicated appendicitis and the patient’s preferences for different treatment options will be assessed.Ethics and disseminationEthical approval was granted by the Amsterdam UMC Medical Ethics Committee (reference W19_416 # 19.483). Because of the observational nature of this study, the study does not fall under the scope of the Medical Research Involving Human Subjects Act. Results will be presented in peer-reviewed journals. This protocol is submitted for publication before analysis of the results. |
| Databáze: | OpenAIRE |
| Externí odkaz: |
|