Denizbasi Arzu, Unluer Erol Erden
Department of Emergency Medicine, Marmara University, Istanbul, Turkey.
Eur J Emerg Med. 2003 Dec;10(4):296-301. doi: 10.1097/00063110-200312000-00011.
To compare the accuracy of diagnosing appendicitis between emergency medicine residents using the Alvarado score and general surgery residents using ultrasonography and their clinical provision.
A total of 358 patients (192 men and 166 women) were admitted to the emergency service with suspected appendicitis. Each patient was evaluated by an emergency medicine resident and then by a general surgeon independently. Age, sex, operational data, diagnosis, and the Alvarado scores were measured.
The sensitivity and specificity of the Alvarado score were 95.4% (95% confidence interval 91-99%) and 45.7% (95% confidence interval 37.4-54%), respectively. There was a significant difference between the sexes in the predictive values of a positive test (P=0.045) and a negative test (P=0.02). There was no statistical difference between the emergency medicine residents and general surgery residents in terms of positive and negative predicitive values (P>0.05 each).
There was no statistical difference between the emergency medicine residents using the Alvarado score and the general surgery residents in terms of suspecting the diagnosis of appendicitis.
比较使用阿尔瓦拉多评分的急诊医学住院医师与使用超声检查的普通外科住院医师在诊断阑尾炎方面的准确性及其临床诊断情况。
共有358例疑似阑尾炎患者（192例男性和166例女性）入住急诊服务部门。每位患者先由急诊医学住院医师进行评估，然后再由普通外科医生独立评估。记录患者的年龄、性别、手术数据、诊断结果以及阿尔瓦拉多评分。
阿尔瓦拉多评分的敏感性和特异性分别为95.4%（95%置信区间91 - 99%）和45.7%（95%置信区间37.4 - 54%）。阳性检测预测值（P = 0.045）和阴性检测预测值（P = 0.02）在性别之间存在显著差异。急诊医学住院医师和普通外科住院医师在阳性和阴性预测值方面无统计学差异（P均>0.05）。
在怀疑阑尾炎诊断方面，使用阿尔瓦拉多评分的急诊医学住院医师与普通外科住院医师之间无统计学差异。
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