DIAGNOSIS WORKSHEET Citation: Diagnostic Value of Ultrasonography in Patients Suspected Acute Appendicitis Elahifar M A, Taheri H, igha!

ian A" Are the results of this diagnostic stud !alid" #as there an independent, $lind co!parison %ith a reference &'gold() standard of diagnosis* #es$ Ultrasound %as carried out $y radiology residents, $y the use of high+resolution !ode ultrasonography &!odel ,-./0 12 .E) %ith linear and cur3ed transducers %ith ultrasound fre4uencies ranged $et%een 567 and 167 MH86 The diagnostic criteria for acute appendicitis in US including !a9i!u! dia!eter greater than : !!, lac; of co!pressi$ility, hypere!ia on Doppler, the presence of free fluid in the right lo%er 4uadrant and infiltration of the periappendiceal fat6 Sonographic results Elahifar et al6 Diagnostic Value of Ultrasonography in Patients Suspected Acute Appendicitis %ere classified as either 'positi3e( or 'negati3e6( The histopathological diagnosis of acute appendicitis %as confir!ed $y the presence of poly!orphonuclear cells in the !uscular layer &trans!ural infiltration) of the appendicular %all6 #hite $lood cell count &# 0) higher than <=7==>!!? %as accepted as leu;ocytosis6 #es$ /n a cross+sectional retrospecti3e study, %e collected the data of 5== consecuti3e patients %ith a$do!inal pain that undergoing appendecto!y, fro! @une 5==A to April 5=<5 in E!a! Ali Hospital of Bahedan Uni3ersity of Medical Science6 Patients ha3e not Pathology reports of appendices %ere e9cluded fro! the study6 The study %as appro3ed $y ethical co!!ittee and all participants pro3ided %ritten consent6Cor each patient %e collected the data includingD de!ographic infor!ation &age, se9), history

#as the diagnostic test e3aluated in an appropriate spectru! of patients &li;e those in %ho! it %ould $e used in practice)*

#as the reference standard applied regardless of the diagnostic test result*

of pain, physical e9a!ination, la$oratory assess!ent including # 0, preoperati3e US, operati3e findings and pathology report6 #es$ Cinal diagnosis of appendicitis %as confir!ed $y histopathological e9a!ination6 Eesults %ere co!pared %ith US6 The sensiti3ity and specificity of all US i!ages %ere calculated $ased on the pathology results of the appendecto!y6

Are the !alid results of this diagnostic stud i%&ortant"

'alue

(
1= J A=65 J A? J

Sensiti3ity Specificity Positi3e predicti3e 3alue

Diagnostic Values of the a$do!inal ultrasound in acute appendicitis &n F5==)6 ,E G sensitifitas > &<+spesifisitas) F =,1> &<+=,A=5) F 1,<H hasil uIi diagnostic yang positif ;uat !e!$eri;an nilai yang Iauh le$ih $esar dari < ,E + &<+spesifisitas) > sensitifitas F &<+=,A=5) > =,1 F =,<H hasil uIi diagnostic yang negatif ;uat !e!$eri;an nilai !ende;ati = interpretasi nilai ,E 7+<= atau =,<+=,5 !enye$a$;an peru$ahan !oderat

Positi3e Predicti3e Value &PPV) and Kegati3e Predicti3e Value &KPV)

Can ou a&&l this !alid) i%&ortant e!idence a*out a diagnostic test in caring for our &atient" /s the diagnostic test a3aila$le, afforda$le, #es$ accurate, and precise in your setting* 0an you generate a clinically sensi$le #es$ esti!ate of your patientLs pre+test pro$a$ility &fro! personal e9perience, pre3alence statistics, practice data$ases, or pri!ary studies)* #ill the resulting post+test pro$a$ilities affect your !anage!ent and help your patient* #ould the conse4uences of the test help your patient* #es$

#es$