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Cited by 357

The DOI matches its Crossref record; 5 of the 5 references it cites were found in a registry or an index.

Acute Appendicitis: Meta-Analysis of Diagnostic Performance of CT and Graded Compression US Related to Prevalence of Disease

van Randen, Adrienne, Bipat, Shandra, Zwinderman, Aeilko H., Ubbink, Dirk T., Stoker, Jaap, Boermeester, Marja A.·2008·Radiology

Abstract

PURPOSE: This study was a head-to-head comparison of graded compression ultrasonography (US) and computed tomography (CT) in helping diagnose acute appendicitis with an emphasis on diagnostic value at different disease prevalences, commonly occurring in various hospital settings. MATERIALS AND METHODS: MEDLINE, EMBASE, CINAHL, and Cochrane databases were searched from January 1966 to February 2006. Prospective trials were selected if they (a) compared graded compression US and CT in the same patient population; (b) included more than 10 patients, otherwise, the study was considered a case report; (c) evaluated mainly adults or adolescents; (d) used surgery and/or clinical follow-up as reference standard; and (e) reported data to calculate 2 x 2 contingency tables for graded compression US and CT. Estimates of sensitivity, specificity, and positive and negative likelihood ratios (LRs) for US and CT were calculated. Posttest probabilities after CT and US were calculated for various clinically relevant prevalences. RESULTS: Six studies were included, evaluating 671 patients (mean age range, 26-38 years); prevalence of acute appendicitis was 50% (range, 13%-77%). Positive LR was 9.29 (95% confidence interval [CI]: 6.9, 12.6) for CT and 4.50 (95% CI: 3.0, 6.7; P = .011) for US, yielding posttest probabilities for positive tests of 90% and 82%, respectively. Negative LR was 0.10 (95% CI: 0.06, 0.17) for CT and 0.27 (95% CI: 0.17, 0.43) for US (P = .013), resulting in posttest probabilities of 9% and 21%, respectively. Posttest probabilities for positive tests were markedly decreased at lower prevalences. CONCLUSION: In head-to-head comparison studies of diagnostic imaging, CT had a better test performance than did graded compression US in diagnosing appendicitis. Ignoring the relationship between prevalence (pretest probability) and diagnostic value may lead to an inaccurate estimation of diagnostic performance.

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Metadata

Authors
van Randen, A., Bipat, S., Zwinderman, A. H., Ubbink, D. T., Stoker, J., & Boermeester, M. A.
Venue
Radiology
Published
2008-10
Volume
249
Issue
1
Pages
97-106
ISSN
  • 0033-8419 (ISSN-L)
  • 1527-1315
OpenAlex
W2103538002
Cited by
357
References
5
FWCI
5.48
Type
journal article
Language
en
Open access
closed

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CoChat. (2026). Citation check: Acute Appendicitis: Meta-Analysis of Diagnostic Performance of CT and Graded Compression US Related to Prevalence of Disease. https://app.cochat.ai/papers/10.1148/radiol.2483071652
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van Randen, A., Bipat, S., Zwinderman, A. H., Ubbink, D. T., Stoker, J., & Boermeester, M. A. (2008). Acute Appendicitis: Meta-Analysis of Diagnostic Performance of CT and Graded Compression US Related to Prevalence of Disease. Radiology. https://doi.org/10.1148/radiol.2483071652

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