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Q In adults, what is the accuracy of computed tomographic (CT) scanning for diagnosing appendicitis?
Clinical impact ratings GP/FP/Primary care ★★★★★☆☆ Emergency medicine ★★★★★☆☆ Surgery ★★★★★☆☆
Medline (1998 to July 2003) and reference lists of relevant articles.
Study selection and assessment:
English language prospective studies that evaluated the use of CT scanning in the diagnosis of appendicitis in adults. Studies including children only were excluded.
sensitivity, specificity, and accuracy of CT scanning in the diagnosis of appendicitis.
23 studies used prospective designs to address the diagnostic accuracy of CT scanning. In these studies, the numbers of patients ranged between 31 and 308. CT features used to diagnose acute appendicitis included appendiceal diameter >6 mm with periappendiceal inflammation, non-opacification with oral or rectal contrast material with periappendiceal inflammation, or the presence of an appendicolith. In all studies, the diagnostic standard was pathological diagnosis if the patient had an appendectomy or prolonged follow up (usually 3 mo) if the patient did not have an appendectomy. Studies reported that the sensitivity of CT scanning ranged from 77–100%, …