{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,19]],"date-time":"2026-10-19T17:14:30Z","timestamp":1792430070068,"version":"4.5.0"},"reference-count":36,"publisher":"Oxford University Press (OUP)","issue":"8","license":[{"start":{"date-parts":[[2021,2,6]],"date-time":"2021-02-06T00:00:00Z","timestamp":1612569600000},"content-version":"vor","delay-in-days":1027,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2018,6,14]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>The intraoperative classification of appendicitis dictates the patient's postoperative management. Prolonged antibiotic prophylaxis is recommended for complex appendicitis (gangrenous, perforated, abscess), whereas preoperative prophylaxis suffices for simple appendicitis. Distinguishing these two conditions can be challenging. The aim of this study was to assess interobserver variability in the classification of appendicitis during laparoscopy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>Short video recordings taken during laparoscopy for suspected appendicitis were shown to surgeons and surgical residents. They were asked to: classify the appendix as indicative of no, simple or complex appendicitis; categorize the appendix as normal, phlegmonous, gangrenous, perforated and\/or abscess; and decide whether they would prescribe postoperative antibiotics. Inter-rater reliability was evaluated using Fleiss' \u03ba score and the S* statistic.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Some 80 assessors participated in the study. Video recordings of 20 patients were used. Interobserver agreement was minimal for both the classification of appendicitis (\u03ba score 0\u00b7398, 95 per cent c.i. 0\u00b7385 to 0\u00b7410) and the decision to prescribe postoperative antibiotic treatment (\u03ba score 0\u00b7378, 0\u00b7362 to 0\u00b7393). Agreement was slightly higher when published criteria were applied (\u03ba score 0\u00b7552, 0\u00b7537 to 0\u00b7568).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There is considerable variability in the intraoperative classification of appendicitis and the decision to prescribe postoperative antibiotic treatment.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/bjs.10837","type":"journal-article","created":{"date-parts":[[2018,4,16]],"date-time":"2018-04-16T23:53:15Z","timestamp":1523922795000},"page":"1014-1019","source":"Crossref","is-referenced-by-count":39,"title":["Interobserver variability in the classification of appendicitis during laparoscopy"],"prefix":"10.1093","volume":"105","author":[{"given":"A L","family":"van den Boom","sequence":"first","affiliation":[{"name":"Department of Surgery, Erasmus MC \u2013 University Medical Centre, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E M L","family":"de Wijkerslooth","sequence":"additional","affiliation":[{"name":"Department of Surgery, Erasmus MC \u2013 University Medical Centre, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K A L","family":"Mauff","sequence":"additional","affiliation":[{"name":"Department of Biostatistics, Erasmus MC \u2013 University Medical Centre, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"I","family":"Dawson","sequence":"additional","affiliation":[{"name":"Department of Surgery, IJsselland Ziekenhuis, Capelle a\/d IJssel, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C C","family":"van Rossem","sequence":"additional","affiliation":[{"name":"Department of Surgery, Maasstad Ziekenhuis, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B R","family":"Toorenvliet","sequence":"additional","affiliation":[{"name":"Department of Surgery, Ikazia Ziekenhuis, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"B P L","family":"Wijnhoven","sequence":"additional","affiliation":[{"name":"Department of Surgery, Erasmus MC \u2013 University Medical Centre, Rotterdam, The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2018,4,16]]},"reference":[{"key":"2021020616594848600_bjs10837-bib-0001","doi-asserted-by":"crossref","first-page":"910","DOI":"10.1093\/oxfordjournals.aje.a115734","article-title":"The epidemiology of appendicitis and appendectomy in the United States","volume":"132","author":"Addiss","year":"1990","journal-title":"Am J Epidemiol"},{"key":"2021020616594848600_bjs10837-bib-0002","doi-asserted-by":"crossref","first-page":"769","DOI":"10.1007\/s00104-002-0512-7","article-title":"[Status report on epidemiology of 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