Evidence map›Paper›PMID 42646659›Full record

ReviewPediatric reports2026

Comparison of the Alvarado Score with Alternative Diagnostic Tools in Pediatric Acute Appendicitis: A Literature Review.

Paul Tchouala Tchakoute, Alin Iuhas, Vlad-Ionuț Nechita, Andrei Vasile Pașcalău, Buzdugan Mihaela Ștefania, Ion Cosmin Puia

Abstract readReview
In one paragraph

Review in Pediatric reports, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.

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

0 citing papers in PubMed.

No citing paper in PubMed yet.

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.

Paul Tchouala TchakouteDoctoral School of Biomedical Sciences, University of Oradea, 410073 Oradea, Romania.ORCID 0009-0005-0030-3532
Alin IuhasDepartment of Medical Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania.ORCID 0000-0002-2463-8100
Vlad-Ionuț NechitaDepartment of Fundamental Sciences, Discipline of Medical Informatics, Research Methodology and Data Analysis, Faculty of Nursing and Health Sciences (FAMSS), "Iuliu Hațieganu" University of Medicine and Pharmacy, 400012 Cluj-Napoca, Romania.ORCID 0000-0002-3097-707X
Andrei Vasile PașcalăuDepartment of Morphological Disciplines, Faculty of Medicine and Pharmacy, University of Oradea, 410087 Oradea, Romania.
Buzdugan Mihaela ȘtefaniaDoctoral School of Biomedical Sciences, University of Oradea, 410073 Oradea, Romania.ORCID 0009-0005-2638-2021
Ion Cosmin PuiaDoctoral School of Biomedical Sciences, University of Oradea, 410073 Oradea, Romania.ORCID 0000-0002-2638-9056

Funding

University of Oradea
6 · The paper itself

Abstract

backgroundAcute appendicitis is a leading pediatric surgical emergency. Timely diagnosis remains challenging, particularly in young children with atypical presentations. Clinical evaluation alone yields variable diagnostic performance, prompting the use of risk stratification tools.

objectiveTo evaluate and compare the Alvarado score against alternative clinical scoring systems, laboratory biomarkers, and imaging modalities in pediatric acute appendicitis.

methodsA narrative literature review with structured selection elements was conducted across PubMed, Scopus, and Web of Science for studies published between 2016 and 2026.

resultsThe Alvarado score demonstrates moderate diagnostic accuracy in children, with good sensitivity but limited specificity (57-76%) at standard cut-offs (≥7). Pediatric-specific scores like the Pediatric Appendicitis Score (PAS) offer higher sensitivity, while the Appendicitis Inflammatory Response (AIR) score provides superior specificity and better identifies complicated appendicitis (including gangrene, phlegmon, and perforation). Continuous risk models, notably the Pediatric Appendicitis Risk Calculator (pARC), outperform fixed additive scores in pediatric cohorts. Combining clinical scores with C-reactive protein, neutrophil-to-lymphocyte ratio, and selective ultrasonography enhances diagnostic precision. Computed tomography reserved for equivocal cases further optimizes diagnostic yield.

conclusionThe Alvarado score should not be used as a standalone tool. A structured, stepwise multimodal approach integrating clinical scores (such as pARC or PAS), inflammatory biomarkers, and selective imaging optimizes diagnostic accuracy and supports timely surgical decision-making in children.

Indexed as

acute appendicitisAIR scoreAlvarado scorediagnostic accuracypARCPASpediatrics

Identifiers

PMID42646659
PMCPMC13516179

What OpenQuestion holds

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Registered trials

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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.