ArticleJournal of pediatric surgery2017
Improving ultrasound for appendicitis through standardized reporting of secondary signs.
Article in Journal of pediatric surgery, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03522233 (Clinical Outcomes and Charges After Risk Stratification by Pediatric Appendicitis Risk Calculator), which is not on this map. Cited by 15 papers, 1 of them a synthesis that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Clinical Outcomes and Charges After Risk Stratification by Pediatric Appendicitis Risk Calculator (pARC) in Children With Appendix Ultrasounds at a Tertiary Care Pediatric Hospital
Who cites it
15 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Swedish national guidelines for diagnosis and management of acute appendicitis in adults and children.BJS open · 2025Guideline
- Review
- C-Reactive Protein, International Normalized Ratio, and Fibrinogen in Diagnostic Scale of Complicated Acute Appendicitis.Clinics and practice · 2025Article
- Non-operative treatment of acute appendicitis in children: clinical efficacy of amoxicillin-clavulanic acid in a retrospective single-centre study.BMJ paediatrics open · 2023Article
- Added Value of Structured Reporting for US of the Pediatric Appendix: Additional CT Examinations and Negative Appendectomy.Journal of the Korean Society of Radiology · 2023Article
- Structured Reporting for Pediatric Appendiceal US: Can It Reduce CT Utilization Rate and Decrease the Negative Appendectomy Rate?Journal of the Korean Society of Radiology · 2023Article
- A novel Appendicitis TriMOdal prediction Score (ATMOS) for acute appendicitis in pregnancy: a retrospective observational study.Updates in surgery · 2022Observational
- Pediatric appendiceal ultrasound: maintaining accuracy, increasing determinacy and improving clinical outcomes following the introduction of a standardized reporting template.Pediatric radiology · 2021Article
- The Modified Heidelberg and the AI Appendicitis Score Are Superior to Current Scores in Predicting Appendicitis in Children: A Two-Center Cohort Study.Frontiers in pediatrics · 2020Article
- Structured Reporting versus Free-Text Reporting for Appendiceal Computed Tomography in Adolescents and Young Adults: Preference Survey of 594 Referring Physicians, Surgeons, and Radiologists from 20 Hospitals.Korean journal of radiology · 2019Article
- 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
- Article
- Paediatric appendiceal ultrasound: a survey of Australasian sonographers' opinions on examination performance and sonographic criteria.Journal of medical radiation sciences · 2018Article
- Importance of Compliance Audits for a Pediatric Complicated Appendicitis Clinical Practice Guideline.Journal of medical systems · 2018Article
Corrections and comments
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Authors and funding
8 authors.
Funding
Abstract
objectiveOur aim was to implement a standardized US report that included secondary signs of appendicitis (SS) to facilitate accurate diagnosis of appendicitis and decrease the use of computed tomography (CT) and admissions for observation.
methodsA multidisciplinary team implemented a quality improvement (QI) intervention in the form of a standardized US report and provided stakeholders with monthly feedback. Outcomes including report compliance, CT use, and observation admissions were compared pretemplate and posttemplate.
resultsWe identified 387 patients in the pretemplate period and 483 patients in the posttemplate period. In the posttemplate period, the reporting of SS increased from 5.4% to 79.5% (p<0.001). Despite lower rates of appendix visualization (43.9% to 32.7%, p<0.001) with US, overall CT use (8.5% vs 7.0%, p=0.41) and the negative appendectomy rate remained stable (1.0% vs 1.0%, p=1.0). CT utilization for patients with an equivocal ultrasound and SS present decreased (36.4% vs 8.9%, p=0.002) and admissions for observations decreased (21.5% vs 15.3%, p=0.02). Test characteristics of RLQ US for appendicitis also improved in the posttemplate period.
conclusionA focused QI initiative led to high compliance rates of utilizing the standardized US report and resulted in lower CT use and fewer admissions for observation. Study of a Diagnostic Test Level of Evidence: 1.
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