Cougard 2002.
Study characteristics | |||
Patient sampling | Patients had been admitted with suspected appendicitis. No exclusion criteria were reported Recruitment period: February 1998 to February 2000 |
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Patient characteristics and setting | Age range: not reported; mean age 33.9 years. The proportion of patients younger than 16 years is unclear. 61% women
General hospital in Dijon, France. Single‐centre study Disease spectrum: unclear |
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Index tests | Helical CT of the abdomen with IV contrast enhancement. Number of slices, slice thickness, slice interval, voltage, and mAs product: not stated | ||
Target condition and reference standard(s) | Appendicitis. Histopathological findings were reported in patients who had surgery with appendectomy. Intraoperative findings were noted for patients who had surgery without appendectomy. Follow‐up was 2 months for patients who did not have surgery | ||
Flow and timing | 89 patients were included. It is unclear whether any patients were excluded or dropped out. 60 patients had surgery; 44 had appendicitis; 29 were followed up for 2 months; none of these had an appendectomy | ||
Comparative | |||
Criteria for CT diagnosis of appendicitis | Appendix diameter > 5 mm, appendicolith, appendix wall thickening with hyperenhancement, periappendiceal or pericaecal fat stranding, fluid collection around the appendix or in the pouch of Douglas | ||
Assessors of the CT‐scan | Not stated | ||
Notes | |||
Methodological quality | |||
Item | Authors' judgement | Risk of bias | Applicability concerns |
DOMAIN 1: Patient Selection | |||
Was a consecutive or random sample of patients enrolled? | Unclear | ||
Did the study avoid inappropriate exclusions? | Unclear | ||
Does the study population represent an unselected sample of adults with suspected appendicitis? | Unclear | ||
Unclear | Unclear | ||
DOMAIN 2: Index Test All tests | |||
Were the index test results interpreted without knowledge of the results of the reference standard? | Yes | ||
If a threshold was used, was it pre‐specified? | Yes | ||
Is the index test described in sufficient detail to permit its replication? | No | ||
Was the analysis based on the initial evaluation of the CT‐scan by the radiologist on call? | No | ||
Low | High | ||
DOMAIN 3: Reference Standard | |||
Is the reference standards likely to correctly classify the target condition? | No | ||
Were the reference standard results interpreted without knowledge of the results of the index tests? | Unclear | ||
High | Low | ||
DOMAIN 4: Flow and Timing | |||
Did all patients receive a reference standard? | Yes | ||
Did all patients receive the same reference standard? | No | ||
Did all patients with a positive CT‐scan have surgery? | Yes | ||
Did all patients with a negative CT‐scan have clinical follow‐up? | No | ||
Was the choice of reference standard independent of the result of the index test? | No | ||
Were all patients included in the analyses? | Yes | ||
High |