Karabulut 2014.
Study characteristics | |||
Patient sampling | Patients with suspected appendicitis were included. No exclusion criteria were reported Recruitment period: December 2005 to December 2008 |
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Patient characteristics and setting | Age range (mean): 6 to 77 years (27) ‐ proportion younger than 15 years not reported (study authors contacted ‐ no response). 52% women. Exclusion criteria not reported Disease spectrum and clinical setting: not stated. Single‐centre study |
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Index tests | Two helical CT‐scanners were used: Brillance 16 (Philips Medical Systems): 16‐slice. Slice thickness: 3 mm. Slice interval: 1.5 mm. Voltage: 120 kV. mAs product: 50 mAs. Unenhanced. Lower abdomen MW8000 (Philips Medical Systems): 2‐slice. Slice thickness: 3.2 mm. Slice interval: 1.6 mm. Voltage: 120 kV. mAs product: 50 mAs. Unenhanced. Lower abdomen |
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Target condition and reference standard(s) | Appendicitis. Histological examination in patients who had an appendectomy. Otherwise alternative intraoperative findings. Follow‐up in patients who did not have surgery ‐ review of medical charts and/or a telephone call after 21 to 31 days | ||
Flow and timing | 104 patients were recruited. All had CT of the lower abdomen, 40 had surgery, and 39 had appendicitis confirmed histologically. 64 patients were followed up | ||
Comparative | |||
Criteria for CT diagnosis of appendicitis | Enlarged outer appendix diameter (threshold not stated), thickened appendix wall, appendicolith, periappendicular fat stranding, pericaecal or periappendicular fluid or abscess. Enlarged appendix diameter was not accepted as a single criterion unless it was accompanied by intraluminal, mural, or periappendicular soft tissue changes | ||
Assessors of the CT‐scan | 1 senior radiologist | ||
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? | Unclear | ||
If a threshold was used, was it pre‐specified? | Yes | ||
Is the index test described in sufficient detail to permit its replication? | Yes | ||
Was the analysis based on the initial evaluation of the CT‐scan by the radiologist on call? | Unclear | ||
Unclear | Unclear | ||
DOMAIN 3: Reference Standard | |||
Is the reference standards likely to correctly classify the target condition? | Yes | ||
Were the reference standard results interpreted without knowledge of the results of the index tests? | Unclear | ||
Unclear | 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? | No | ||
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 |