Department of Surgery, Center for Perioperative Optimization, Herlev and Gentofte Hospital, University of Copenhagen, Borgmester Ib Juuls Vej 1, 2730, Herlev, Denmark.
Surg Endosc. 2023 May;37(5):3419-3429. doi: 10.1007/s00464-023-09890-2. Epub 2023 Feb 3.
We aimed to provide an overview of all diagnostic tools developed to diagnose appendicitis with their reported accuracy and to further characterize these including their need for diagnostic equipment.
This scoping review followed the Preferred Reporting Items for Systematic reviews and Meta-Analyses extension for Scoping Reviews and a protocol was registered at Open Science Framework. We performed a systematic literature search in PubMed, Embase, China National Knowledge Infrastructure, Índice Bibliográfico Espanhol de Ciências da Saúde, and Latin American and Caribbean Health Sciences Literature. We included original articles of all languages with the purpose to derive an accessible diagnostic tool. We extracted data regarding study- and diagnostic tool characteristics, and the accuracy of each diagnostic tool.
The search led to 6419 records, where 74 studies were included, yielding 82 diagnostic tools reported in seven different languages. Among these tools, 35% included patient characteristics, 85% symptoms, 93% physical examinations, 37% vital signs, 78% laboratory values, and 16% imaging. Among the diagnostic tools, 35% relied on a medical doctor/surgeon with access to a laboratory, and six diagnostic tools did not require a bedside medical doctor/surgeon. The median positive predictive value, negative predictive value, sensitivity, and specificity across diagnostic tools were 91%, 94%, 89%, and 86%, respectively.
We identified 82 diagnostic tools that most frequently were based on symptoms and physical examinations. Most diagnostic tools relied on a medical doctor/surgeon with access to laboratory values. The accuracy was high across the diagnostic tools.
我们旨在提供所有用于诊断阑尾炎的诊断工具的概述，包括其报告的准确性，并进一步对这些工具进行特征描述，包括它们对诊断设备的需求。
本范围综述遵循系统评价和荟萃分析扩展的首选报告项目，并在开放科学框架上进行了注册。我们在 PubMed、Embase、中国知识基础设施、Índice Bibliográfico Espanhol de Ciências da Saúde 和拉丁美洲和加勒比健康科学文献中进行了系统文献检索。我们纳入了所有语言的原始文章，旨在得出一种易于使用的诊断工具。我们提取了关于研究和诊断工具特征以及每种诊断工具准确性的数据。
搜索结果产生了 6419 条记录，其中包括 74 项研究，共报告了 82 种不同语言的诊断工具。这些工具中，35%包含患者特征，85%包含症状，93%包含体格检查，37%包含生命体征，78%包含实验室值，16%包含影像学检查。在这些诊断工具中，35%依赖于有实验室资源的医生/外科医生，有 6 种诊断工具不需要床边的医生/外科医生。在整个诊断工具中，阳性预测值、阴性预测值、敏感度和特异度的中位数分别为 91%、94%、89%和 86%。
我们确定了 82 种诊断工具，这些工具最常基于症状和体格检查。大多数诊断工具依赖于有实验室资源的医生/外科医生。这些诊断工具的准确性较高。
