Pakaneh 2008.
Study characteristics | |||
Patient sampling | Patients with a clinical diagnosis of appendicitis were candidates for appendectomy. Patients with long‐lasting abdominal pain, patients with suspected perforated appendix, and patients with unstable haemodynamics were excluded Recruitment period: May to July 2006 |
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Patient characteristics and setting | Age range (median): 13 to 76 years (25). 26% women Department of Surgery, Imam Khomeini Hospital, Tehran, Iran. Single‐centre study Disease spectrum: high suspicion of appendicitis |
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Index tests | Unenhanced helical CT of the lower abdomen. Slice thickness: 5 mm. Slice interval, voltage, and mAs product: not stated. Manufacturer of CT‐scanner, model name, and slice number: not stated | ||
Target condition and reference standard(s) | Appendicitis. All patients had surgery with appendectomy and histological assessment of the removed appendix as the reference test | ||
Flow and timing | 50 patients were included; all had surgery, and 42 had appendicitis confirmed histologically | ||
Comparative | |||
Criteria for CT diagnosis of appendicitis | Positive CT findings were defined as presence of at least 1 of the following: appendix diameter > 6 mm, periappendiceal fat stranding, appendicolith, periappendiceal free fluid, flegmone or abscess | ||
Assessors of the CT‐scan | |||
Notes | |||
Methodological quality | |||
Item | Authors' judgement | Risk of bias | Applicability concerns |
DOMAIN 1: Patient Selection | |||
Was a consecutive or random sample of patients enrolled? | Yes | ||
Did the study avoid inappropriate exclusions? | Yes | ||
Does the study population represent an unselected sample of adults with suspected appendicitis? | No | ||
Low | High | ||
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? | Unclear | ||
Low | High | ||
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 | High | ||
DOMAIN 4: Flow and Timing | |||
Did all patients receive a reference standard? | Yes | ||
Did all patients receive the same reference standard? | Yes | ||
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? | Yes | ||
Were all patients included in the analyses? | Yes | ||
Low |