SynthesisBJS open2021
Discriminating complicated from uncomplicated appendicitis by ultrasound imaging, computed tomography or magnetic resonance imaging: systematic review and meta-analysis of diagnostic accuracy.
Synthesis in BJS open, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 35 papers, 3 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
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.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
35 citing papers in PubMed, 3 syntheses or guidelines pooled it, 52 citations in OpenAlex.
- Swedish national guidelines for diagnosis and management of acute appendicitis in adults and children.BJS open · 2025Guideline
- Rapid MRI Abdomen for Assessment of Clinically Suspected Acute Appendicitis in the General Adult Population: a Systematic Review.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2023Pooled it
- Randomized clinical trials comparing antibiotic therapy with appendicectomy for uncomplicated acute appendicitis: meta-analysis.BJS open · 2022Pooled it
- Article
- Appendiceal abscess: pathologic definitions and a diagnostic framework-SIRC/SICUT consensus.International journal of colorectal disease · 2026Article
- Development and internal validation of a risk-stratification model for complicated appendicitis in the elderly: a retrospective comparative study.BMC gastroenterology · 2026Article
- Non-operative Management of Uncomplicated Appendicitis: A Review of Indications, Safety, and Clinical Algorithms.Cureus · 2026Review
- Low-keV virtual monoenergetic images with rapid kilovoltage-switching DECT for differentiating complicated from uncomplicated appendicitis in adults.Abdominal radiology (New York) · 2026Article
- Preoperative differentiation of acute appendicitis using NLR, SII, and maximum appendiceal diameter: a retrospective single-center diagnostic study.Frontiers in surgery · 2026Article
- Necrosis of the diaphragm pleural empyema and pneumomediastinum as rare complications of appendicitis: A case report.IDCases · 2026Article
- Appendicitis.Nature reviews. Disease primers · 2025Review
- Complicated appendicitis: value of inflammatory markers based on EAES 2015 guidelines.Surgical endoscopy · 2025Article
- Progress in the application of machine learning in CT diagnosis of acute appendicitis.Abdominal radiology (New York) · 2025Review
- Predictive Value of Clinical and CT Scan Findings for Complicated Appendicitis: A Retrospective Analysis.Cureus · 2025Article
- Clinical outcomes and optimal indications for nonoperative management of acute appendicitis in adult patients: a comprehensive literature review.Annals of coloproctology · 2025Review
- An Observational Review of Tonsillectomy and Appendectomy Procedures Conducted at a Tertiary Care Hospital.Cureus · 2025Article
- Development and validation of a nomogram for predicting perforation in the early 24 h of acute appendicitis.SAGE open medicine · 2025Article
- Update on the Diagnosis and Treatment of Acute Appendicitis.Journal of clinical medicine · 2024Article
- Diagnostic Value of Serum Sodium Level and Neutrophil-to-Lymphocyte Ratio in Predicting Severity of Acute Appendicitis: A Retrospective Cross-Sectional Two-Center Study.Medicina (Kaunas, Lithuania) · 2024Article
- Computed tomography and clinical outcomes in the diagnosis of acute appendicitis: Significance of periappendiceal fat tissue.Ulusal travma ve acil cerrahi dergisi = Turkish journal of trauma & emergency surgery : TJTES · 2024Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundDiscriminating complicated from uncomplicated appendicitis is crucial. Patients with suspected complicated appendicitis are best treated by emergency surgery, whereas those with uncomplicated appendicitis may be treated with antibiotics alone. This study aimed to obtain summary estimates of the accuracy of ultrasound imaging, CT and MRI in discriminating complicated from uncomplicated appendicitis.
methodsA systematic literature review was conducted by an electronic search in PubMed, Embase and the Cochrane Library for studies describing the diagnostic accuracy of complicated versus uncomplicated appendicitis. Studies were included if the population comprised adults, and surgery or pathology was used as a reference standard. Risk of bias and applicability were assessed with QUADAS-2. Bivariable logitnormal random-effect models were used to estimate mean sensitivity and specificity.
resultsTwo studies reporting on ultrasound imaging, 11 studies on CT, one on MRI, and one on ultrasonography with conditional CT were included. Summary estimates for sensitivity and specificity in detecting complicated appendicitis could be calculated only for CT, because of lack of data for the other imaging modalities. For CT, mean sensitivity was 78 (95 per cent c.i. 64 to 88) per cent, and mean specificity was 91 (85 to 99) per cent. At a median prevalence of 25 per cent, the positive predictive value of CT for complicated appendicitis would be 74 per cent and its negative predictive value 93 per cent.
conclusionUltrasound imaging, CT and MRI have limitations in discriminating between complicated and uncomplicated appendicitis. Although CT has far from perfect sensitivity, its negative predictive value for complicated appendicitis is high.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.