ArticleAmerican journal of surgery2015
Improving ultrasound quality to reduce computed tomography use in pediatric appendicitis: the Safe and Sound campaign.
Article in American journal of surgery, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 17 papers, 1 of them a synthesis that pooled it.
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Who cites it
17 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Systematic review and meta-analysis of the accuracy of MRI to diagnose appendicitis in the general population.Journal of magnetic resonance imaging : JMRI · 2016Pooled it
- New Criteria Could Improve the Success Rate of Non-operative Management of Acute Appendicitis in Children.Cureus · 2022Article
- The unmet demand for point-of-care ultrasound among general pediatricians: a cross-sectional survey.BMC medical education · 2022Article
- Combining Ultrasound with a Pediatric Appendicitis Score to Distinguish Complicated from Uncomplicated Appendicitis in a Pediatric Population.Acta informatica medica : AIM : journal of the Society for Medical Informatics of Bosnia & Herzegovina : casopis Drustva za medicinsku informatiku BiH · 2020Article
- Validation of the Pediatric Appendicitis Risk Calculator (pARC) in a Community Emergency Department Setting.Annals of emergency medicine · 2019Observational
- To determine validity of ultrasound in predicting acute appendicitis among children keeping histopathology as gold standard.Annals of medicine and surgery (2012) · 2019Article
- Improving the value of ultrasound in children with suspected appendicitis: a prospective study integrating secondary sonographic signs.Ultrasonography (Seoul, Korea) · 2019Article
- Focused CT using a height-adjusted metric and the umbilicus as a landmark for children undergoing evaluation for appendicitis.Pediatric radiology · 2017Article
- Imaging in acute appendicitis: What, when, and why?Medical journal, Armed Forces India · 2017Review
- Diagnostic reliability of pediatric appendicitis score, ultrasound and low-dose computed tomography scan in children with suspected acute appendicitis.Therapeutics and clinical risk management · 2017Article
- Secondary signs may improve the diagnostic accuracy of equivocal ultrasounds for suspected appendicitis in children.Journal of pediatric surgery · 2016Article
- Trends in the Use of Medical Imaging to Diagnose Appendicitis at an Academic Medical Center.Journal of the American College of Radiology : JACR · 2016Article
- Contrast-enhanced ultrasound improves accurate identification of appendiceal mucinous adenocarcinoma in an old patient: A case report.Medicine · 2016Article
- How to diagnose acute appendicitis: ultrasound first.Insights into imaging · 2016Article
- WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis.World journal of emergency surgery : WJES · 2016Review
- Campaigns Against Ionizing Radiation and Changed Practice Patterns for Imaging Use in Pediatric Appendicitis.JAMA pediatrics · 2015Article
- Evaluating the value of different sonographic findings in diagnosis of acute appendicitis in children.African journal of paediatric surgery : AJPSArticle
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Authors and funding
9 authors.
Funding
Abstract
backgroundSafety concerns about the use of radiation-based imaging such as computed tomography (CT) in children have resulted in national recommendations to use ultrasound (US) for the diagnosis of appendicitis when possible. We evaluated the trends in CT and US use in a statewide sample and the accuracy of these modalities.
methodsPatients less than or equal to 18 years undergoing appendectomy in Washington State from 2008 to 2013 were evaluated for preoperative US/CT use, as well as imaging/pathology concordance using data from the Surgical Care and Outcomes Assessment Program.
resultsAmong 3,353 children, 98.3% underwent preoperative imaging. There was a significant increase in the use of US first over the study period (P < .001). The use of CT at any time during the evaluation decreased. Despite this, in 2013, over 40% of the children still underwent CT imaging. Concordance between US imaging and pathology varied between 40% and 75% at hospitals performing greater than or equal to 10 appendectomies in 2013. Over one third (34.9%) of CT scans performed in the evaluation of children with appendicitis were performed after an indeterminate US.
conclusionsAlthough the use of US as the first imaging modality to diagnose pediatric appendicitis has increased over the past 5 years, over 40% of children still undergo a CT scan during their preoperative evaluation. Causality for this persistence of CT use is unclear, but could include variability in US accuracy, lack of training, and lack of awareness of the risks of radiation-based imaging. Developing a campaign to focus on continued reduction in CT and increased use of high-quality US should be pursued.
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