Evidence map›Paper›PMID 40577711›Full record

ArticleJMIR research protocols2025

Validation and Comparison of Pediatric Appendicitis Scores and Management Strategies (Project SPASMS): Protocol for a Prospective Multicenter Observational Study.

Wei Hao Lee, Sharon O'Brien, Elizabeth J Mckinnon, Simon Craig, Stuart Dalziel, Michael Collin, Natalie Phillips, Franz E Babl, Sarah Julia Davidson, Shane George and 4 more

Abstract read
In one paragraph

Article in JMIR research protocols, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing 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

2 citing papers in PubMed.

  1. Article
  2. Observational
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

14 authors.

Wei Hao LeeDivision of Paediatrics, School of Medicine, University of Western Australia, Crawley, Australia.ORCID 0000-0002-1212-1286
Sharon O'BrienEmergency Department, Perth Children's Hospital, Nedlands, Australia.ORCID 0000-0002-5980-4682
Elizabeth J MckinnonBiostatistics, The Kids Research Institute Australia, Nedlands, Australia.ORCID 0000-0002-8700-4447
Simon CraigPaediatric Emergency Department, Monash Medical Centre, Monash Health, Clayton, Australia.ORCID 0000-0003-2594-1643
Stuart DalzielEmergency Department, Starship Children's Health, Auckland, New Zealand.ORCID 0000-0003-0522-9579
Michael CollinDepartment of Surgery, Perth Children's Hospital, Nedlands, Australia.ORCID 0000-0001-9273-747X
Natalie PhillipsEmergency Department, Queensland Children's Hospital, Brisbane, Australia.ORCID 0000-0002-7616-5712
Franz E BablDepartments of Paediatrics and Critical Care, University of Melbourne, Parkville, Australia.ORCID 0000-0002-1107-2187
Sarah Julia DavidsonEmergency Department, Sunshine Coast University Hospital, Sunshine Coast, Australia.ORCID 0009-0004-0152-8365
Shane GeorgeChildren's Emergency and Critical Care Collaborative Research Group, Gold Coast University Hospital, Gold Coast, Australia.ORCID 0000-0002-8880-1245
Shefali JaniDepartment of Emergency Medicine, Children's Hospital at Westmead, Sydney, Australia.ORCID 0000-0001-8242-9879
Doris ThamEmergency Department, Royal Children's Hospital, Parkville, Australia.ORCID 0000-0001-6823-6106
Viet TranRoyal Hobart Hospital, Tasmanian Health Service, Hobart, Australia.ORCID 0000-0002-8890-1457
Meredith L BorlandDivision of Paediatrics, School of Medicine, University of Western Australia, Crawley, Australia.ORCID 0000-0002-5326-5008

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundAbdominal pain is a common reason for children to attend the Emergency Department (ED) with acute appendicitis being the most common surgical cause. Various clinical prediction scores (CPSs) have been developed to assist in determining the risk of appendicitis; however, CPSs have been inadequately validated in children and haphazardly adopted in Australia and New Zealand (ANZ) EDs.

objectiveThis study aims to compare and validate various CPSs for diagnosing pediatric appendicitis in children presenting to ANZ EDs.

methodsThis prospective multicenter observational study across 10 ANZ EDs is recruiting children 5-17 years presenting to participating EDs with acute right-sided or generalized abdominal pain lasting ≤7 days and clinician suspicion of appendicitis. CPSs will be calculated by the study team from clinician-recorded data and clinician gestalt recorded on a visual analog scale. Accuracy of CPSs will be assessed by the area under the receiver operating characteristic curve and proportions correctly identified as either low-risk or high-risk based on the CPSs published cutoffs. The final diagnosis of appendicitis will be confirmed on histopathology, and the absence of appendicitis confirmed by telephone, email, or a combination of both to follow up for those discharged directly from ED.

resultsThis study received funding in July 2023 and started enrolment in August 2023. As of October 2024, we have enrolled and completed follow-up on 1227 participants with an expected end date in mid-2025.

conclusionsThis study aims to determine the best-performing CPS for diagnosing pediatric appendicitis in ANZ EDs. Implementation of this CPS in ANZ EDs has the potential to reduce health care costs, rationalize the use of health care resources, and improve the management and outcomes of childhood appendicitis.

trial registrationAustralian New Zealand Clinical Trials Registry ACTRN12622001293752; https://tinyurl.com/242wwenx. INTERNATIONAL REGISTERED REPORT IDENTIFIER (IRRID): DERR1-10.2196/67941.

Indexed as

AppendicitisAbdominal PainAdolescentAustraliaChildChild, PreschoolEmergency Service, HospitalFemaleHumansMaleMulticenter Studies as TopicNew ZealandObservational Studies as TopicProspective Studiesabdominal painappendicitisclinical prediction scoresemergency medicinepediatric

Identifiers

PMID40577711
PMCPMC12254709

What OpenQuestion holds

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LicenceCC BY
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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.