Evidence map›Paper›PMID 34524472›Full record

ArticlePediatric radiology2022

Body mass index as a predictor of sonographic visualization of the pediatric appendix.

Cory M Pfeifer, Luyu Xie, Folefac D Atem, M Sunil Mathew, Desi M Schiess, Sarah E Messiah

Abstract read
PubMed Publisher
In one paragraph

Article in Pediatric radiology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed.

  1. Article
  2. Article
  3. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Cory M PfeiferDepartment of Management, Policy, and Community Health, University of Texas Health Sciences Center, School of Public Health, 1200 Pressler St., Houston, TX, 77030, USA. Cory.Pfeifer@utsouthwestern.edu.ORCID http://orcid.org/0000-0002-2220-9230
Luyu XieCenter for Pediatric Population Health, University of Texas Health Science Center at Houston and Children's Health System of Texas, Dallas, TX, USA.
Folefac D AtemDepartment of Radiology, Texas Children's Hospital, Houston, TX, USA.
M Sunil MathewDepartment of Radiology, Texas Children's Hospital, Houston, TX, USA.
Desi M SchiessDepartment of Radiology, Texas Children's Hospital, Houston, TX, USA.
Sarah E MessiahCenter for Pediatric Population Health, University of Texas Health Science Center at Houston and Children's Health System of Texas, Dallas, TX, USA.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAppendicitis is a common condition that is often confirmed with imaging. Ultrasound (US) is recommended as the first radiologic test in the work-up of appendicitis in children. Increased body mass index (BMI) has been implicated as a limiting factor to the sensitivity of US. This has drastic public health ramifications, as pediatric obesity has been increasing at alarming rates.

objectiveThe purpose of this study is to compare age-adjusted BMI z-scores to the frequency of sonographic visualization of the appendix. MATERIALS AND

methodsA retrospective review of 500 consecutive reports of US exams ordered for appendicitis in patients with a documented BMI was performed. Patients were stratified by BMI z-score based on, and the visualization frequency of the appendix was compared to the BMI z-score group. A logistic regression analysis generated the odds of visualization of the appendix by BMI z-score group. Primary home language, ethnicity, sex and insurance status were included in the logistic regression model to assess these characteristics as potential effect modifiers.

resultsOf the 500 patients, 52.4% were male, 56.4% were Hispanic and 62.0% had government insurance. BMI z-score distribution groups were as follows: 4.2% were <-2, 8.0% were -2 to -1, 49.8% were -1 to 1, 26.4% were 1 to 2 and 11.6% were >2. The visualization frequency was 61.1% for boys and 46.2% for girls (P<0.05). Visualization frequency by BMI z-score group was as follows: 85.7% for <2, 72.5% for -2 to -1, 57.4% for -1 to 1, 47.7% for 1 to 2 and 29.3% for >2. Children with a BMI z-score greater than 2 were less likely to have a US with visualization of the appendix compared to children with a BMI z-score between -1 and 1 (adjusted odds ratio [aOR]: 0.21, 95% CI: 0.11-0.40, P<0.0001). Boys were more likely than girls to have a US with visualization of the appendix (aOR: 1.90, 95% CI: 1.29-2.80, P=0.001). There was no effect from insurance status, ethnicity or primary home language.

conclusionFindings show that as the BMI z-score increased, sonographic visualization of the appendix decreased even after adjusting for demographic differences. These findings have implications for pediatric radiology practice in light of the worsening obesity epidemic.

Indexed as

AppendicitisAppendixBody Mass IndexChildFemaleHumansMaleRetrospective StudiesUltrasonographyAppendicitisAppendixBody mass indexChildrenObesityUltrasound

Identifiers

PMID34524472

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

None linked

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.