Table 3.
Accuracy of Signs
| Signs by Source | Sensitivity | Specificity | Positive Likelihood Ratio (95% Confidence Interval) |
Negative Likelihood Ratio (95% Confidence Interval) |
|---|---|---|---|---|
| RLQ tenderness | ||||
| Summary of level 3 studies | 1.3 (1.1-1.4) | 0.45 (0.35-0.59) | ||
| Pearl et al,20 1995 | 0.97 | 0.05 | 1.0 (0.99-1.1) | 0.54 (0.25-1.1) |
| Kharbanda et al,37 2005 | 0.80 | 0.41 | 1.4 (1.2-1.5) | 0.49 (0.35-0.70) |
| Dolgin et al,47 1992 | 0.81 | 0.52 | 1.7 (1.2-2.3) | 0.37 (0.23-0.61) |
| Paajanen and Somppi,55 1996 | 0.93 | 0.18 | 1.1 (0.97-1.3) | 0.40 (0.12-1.4) |
| Rebound tenderness | ||||
| Summary of level 3 studies | 3.0 (2.3-3.9) | 0.28 (0.14-0.55) | ||
| Kharbanda et al,37 2005 | 0.53 | 0.80 | 2.6 (2.0-3.5) | 0.59 (0.50-0.71) |
| Graham et al,44 1980 | 0.84 | 0.86 | 5.9 (2.4-14.6) | 0.19 (0.13-0.28) |
| Van den Broek,53 2004 | 0.88 | 0.76 | 3.7 (2.0-6.9) | 0.16 (0.08-0.32) |
| Rectal tenderness | ||||
| Summary of level 3 studies | 2.3 (1.3-4.1) | 0.70 (0.56-0.87) | ||
| Dickson and MacKinlay,39 1985 | 0.53 | 0.88 | 4.4 (2.5-7.6) | 0.53 (0.43-0.66) |
| Dixon et al,41 1991 | 0.48 | 0.60 | 1.2 (0.87-1.7) | 0.87 (0.68-1.1) |
| Kharbanda et al,37 2005 | 0.27 | 0.90 | 2.8 (1.3-6.2) | 0.81 (0.67-0.98) |
| Bonello and Abrams,54 1979 | 0.55 | 0.75 | 2.2 (0.65-7.4) | 0.60 (0.38-0.95) |
| Psoas sign | ||||
| Kharbanda et al,37 2005 | 0.36 | 0.86 | 2.5 (1.7-3.7) | 0.75 (0.66-0.86) |
| Lintula et al,48 2005 | 0.26 | 0.87 | 2.0 (0.92-4.1) | 0.86 (0.71-1.0) |
| Localized abdominal tenderness | ||||
| O’Shea et al,35 1988 | 0.21 | 0.81 | 1.1 (0.47-2.4) | 1.0 (0.79-1.2) |
| Pain with percussion, hopping, cough | ||||
| Kharbanda et al,37 2005 | 0.78 | 0.62 | 2.0 (1.7-2.4) | 0.36 (0.26-0.50) |
| Abdominal distention | ||||
| Graham et al,44 1980 | 0.23 | 0.96 | 6.5 (0.93-45.5) | 0.80 (0.71-0.89) |
| Lintula et al,48 2005 | 0.16 | 0.93 | 2.3 (0.82-6.4) | 0.90 (0.78-1.0) |
| Diffuse peritonitis | ||||
| Paajanen and Somppi,55 1996 | 0.24 | 1.00 | 25.0 (1.5-414.1) | 0.76 (0.63-0.90) |
| Abdominal mass | ||||
| Graham et al,44 1980 | 0.12 | 1.00 | 6.9 (0.43-111.0) | 0.90 (0.83-0.97) |
| Guarding | ||||
| Kharbanda et al,37 2005 | 0.62 | 0.63 | 1.6 (1.4-2.0) | 0.61 (0.49-0.76) |
| Dolgin et al,47 1992 | 0.86 | 0.67 | 2.6 (1.7-3.9) | 0.21 (0.12-0.36) |
| Bowel sounds decreased (vs increased/normal) | ||||
| Kharbanda et al,37 2005 | 0.33 | 0.87 | 2.5 (1.6-3.7) | 0.77 (0.68-0.88) |
| CVA tenderness | ||||
| Kharbanda et al,37 2005 | 0.09 | 0.90 | 0.87 (0.45-1.7) | 1.0 (0.95-1.1) |
| Obturator sign | ||||
| Kharbanda et al,37 2005 | 0.28 | 0.87 | 2.2 (1.4-3.4) | 0.82 (0.73-0.93) |
| Rovsing sign | ||||
| Kharbanda et al,37 2005 | 0.30 | 0.84 | 1.9 (1.3-2.8) | 0.83 (0.74-0.93) |