Roupakias Stylianos, Kambouri Katerina, Al Nimer Angelos, Bekiaridou Konstantina, Blevrakis Evangelos, Tsalikidis Christos, Sinopidis Xenophon
School of Medicine, University of Patras, Patras, GRC.
Pediatric Surgery, University Hospital of Alexandroupolis, Alexandroupolis, GRC.
Cureus. 2025 Mar 31;17(3):e81516. doi: 10.7759/cureus.81516. eCollection 2025 Mar.
Uncertainty is inherent in medical practice. False-negative decisions can delay treatments and result in adverse outcomes in children with acute appendicitis (AA). On the other hand, false-positive surgery decisions lead to unnecessary appendectomies. Impressive technological advancements, such as magnetic resonance imaging and laparoscopy, have reduced but failed to eliminate the occurrence of erroneous decisions. Furthermore, there seems to be a fundamental limit to further reduction, especially in eliminating the rates of negative appendectomy or, oppositely, complicated appendicitis. What does this mean for the pediatric surgeon? Will we ever be able to eliminate our mistakes? This systematic review emphasizes the importance of understanding the potential abilities and limitations of different diagnostic options, as well as the impact of decisions in the face of uncertainty.
不确定性是医疗实践中固有的。假阴性诊断可能会延误治疗，并导致急性阑尾炎（AA）患儿出现不良后果。另一方面，假阳性的手术诊断会导致不必要的阑尾切除术。诸如磁共振成像和腹腔镜检查等令人瞩目的技术进步，虽减少但未能消除错误诊断的发生。此外，进一步降低错误诊断，尤其是消除阴性阑尾切除术的发生率，或者相反，消除复杂性阑尾炎的发生率，似乎存在一个根本限制。这对小儿外科医生意味着什么？我们能消除我们的错误吗？本系统评价强调了理解不同诊断方法的潜在能力和局限性，以及面对不确定性时决策影响的重要性。
