Fenyö G
Department of Surgery, Nacka Hospital, Sweden.
Acta Chir Scand. 1987 Sep;153(9):545-51.
Clinical data from 259 patients with suspected acute appendicitis were prospectively collected and used in construction of a Bayesian scoring system, comprising 19 attributes, for preoperative diagnosis. The scoring system was integrated into the routine clinical management of a prospective series of 830 patients. Laparotomy was performed in 310 cases, and of these 256 had acute appendicitis (perforation in 14%). Excluding 6 cases with normal appendix but laparotomy mandatory for other reasons, the negative laparotomy rate was 15.5%. This rate was significantly lower than in earlier series from the same hospital and in more than 8,000 appendectomies performed in Sweden since 1969. The scoring system had 90.2% sensitivity, 91.4% specificity, 82.5% positive predictive value and 95.4% negative predictive value. The system is regarded only as an aid in diagnosis, to be used in combination with clinicians' judgements. Construction of a local data base probably is essential for results equivalent to those here reported.
前瞻性收集了259例疑似急性阑尾炎患者的临床数据，并将其用于构建一个包含19个属性的贝叶斯评分系统，用于术前诊断。该评分系统被纳入一个前瞻性系列830例患者的常规临床管理中。310例患者接受了剖腹手术，其中256例患有急性阑尾炎（14%为穿孔性）。排除6例阑尾正常但因其他原因必须进行剖腹手术的病例后，阴性剖腹手术率为15.5%。该比率显著低于同一医院早期系列以及自1969年以来在瑞典进行的8000多例阑尾切除术中的比率。该评分系统的灵敏度为90.2%，特异度为91.4%，阳性预测值为82.5%，阴性预测值为95.4%。该系统仅被视为诊断辅助工具，需与临床医生的判断结合使用。构建本地数据库可能对于获得与本文报告相当的结果至关重要。
