{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,10]],"date-time":"2026-02-10T17:02:35Z","timestamp":1770742955092,"version":"3.49.0"},"reference-count":19,"publisher":"Wiley","issue":"4","license":[{"start":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T00:00:00Z","timestamp":1739923200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["World j. surg."],"published-print":{"date-parts":[[2025,4]]},"abstract":"<jats:title>ABSTRACT<\/jats:title><jats:sec><jats:title>Background<\/jats:title><jats:p>Diagnosing acute appendicitis often requires biochemical and imaging support which may not be feasible in low\u2010 and middle\u2010income countries (LMICs). The APPEND score, developed in New Zealand, includes C\u2010reactive protein (CRP) which in resource\u2010limited settings, may be hindered by slow processing times. This study aims to evaluate a modified APPEND score (mAPPEND), excluding CRP for diagnosing appendicitis in a New Zealand Pasifika cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>This secondary analysis utilized data from two cohorts (2011 and 2017) from Middlemore Hospital, Auckland. Patients aged \u2265\u00a015\u00a0years with right iliac fossa pain for &lt;\u00a07\u00a0days were included, excluding those with prior appendicectomy or generalized peritonitis. Sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) were calculated, and diagnostic performance was assessed using receiver operating characteristic curve analysis, comparing the area under the curve (AUC) for both scores.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Among 143 Pasifika patients, the AUC for the APPEND and mAPPEND scores were comparable (0.84 vs. 0.85 respectively, <jats:italic>p<\/jats:italic>\u00a0=\u00a00.41). The mAPPEND score demonstrated high diagnostic accuracy with scores between 1 and 2 showing high sensitivity (100% and 97%) and NPV (90% and 92%), scores 4\u20135 showing high specificity (94% and 100%, respectively) and PPV (90% and 100%, respectively), and a score of 3 being the most efficient with a sensitivity of 82% and specificity of 71%.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The mAPPEND score maintains high diagnostic accuracy for appendicitis in a New Zealand Pasifika population. This modified score is a simple and viable tool in settings where CRP testing is unfeasible, supporting its use in Pacific Island countries.<\/jats:p><\/jats:sec>","DOI":"10.1002\/wjs.12510","type":"journal-article","created":{"date-parts":[[2025,2,19]],"date-time":"2025-02-19T09:53:51Z","timestamp":1739958831000},"page":"868-872","source":"Crossref","is-referenced-by-count":2,"title":["Modified APPEND Score for the Diagnosis of Acute Appendicitis in a New Zealand Pasifika Population"],"prefix":"10.1002","volume":"49","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8004-6716","authenticated-orcid":false,"given":"Renato","family":"Pitesa","sequence":"first","affiliation":[{"name":"Department of Surgery The University of Auckland  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8672-6379","authenticated-orcid":false,"given":"Andrew G.","family":"Hill","sequence":"additional","affiliation":[{"name":"Department of Surgery The University of Auckland  Auckland New Zealand"},{"name":"Department of Surgery Middlemore Hospital  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6255-4792","authenticated-orcid":false,"given":"Andrew D.","family":"MacCormick","sequence":"additional","affiliation":[{"name":"Department of Surgery The University of Auckland  Auckland New Zealand"},{"name":"Department of Surgery Middlemore Hospital  Auckland New Zealand"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2025,2,19]]},"reference":[{"key":"e_1_2_9_2_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13017\u2010020\u201000306\u20103"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/ciae348"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010017\u20103926\u20106"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jss.2019.11.022"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.3390\/diseases11040132"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1002\/ajhb.23646"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00384\u2010016\u20102713\u20104"},{"key":"e_1_2_9_9_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.14022"},{"key":"e_1_2_9_10_1","doi-asserted-by":"publisher","DOI":"10.1097\/ta.0000000000002674"},{"key":"e_1_2_9_11_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.amsu.2021.103219"},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.14203"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.1177\/1750458920928473"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1097\/TA.0000000000001422"},{"issue":"8","key":"e_1_2_9_15_1","first-page":"154","article-title":"An Analysis of the Consequences of Acute Appendicitis Between Urban and Rural Patients in Bangladesh","volume":"11","author":"Iqbal T.","year":"2021","journal-title":"Journal of Applied Pharmaceutical Science"},{"issue":"1230","key":"e_1_2_9_16_1","article-title":"Appendicitis in South Auckland, New Zealand","volume":"119","author":"Mahmoud M.","year":"2006","journal-title":"New Zealand Medical Journal"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1111\/ans.12829"},{"key":"e_1_2_9_18_1","doi-asserted-by":"publisher","DOI":"10.1038\/s41598\u2010020\u201058847\u20101"},{"key":"e_1_2_9_19_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00268\u2010021\u201006290\u20102"},{"key":"e_1_2_9_20_1","volume-title":"Demographic Profile: 2018 Census, Population of Counties Manukau","author":"Lees J.","year":"2021"}],"container-title":["World Journal of Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/wjs.12510","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,10]],"date-time":"2025-10-10T01:13:42Z","timestamp":1760058822000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/wjs.12510"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,2,19]]},"references-count":19,"journal-issue":{"issue":"4","published-print":{"date-parts":[[2025,4]]}},"alternative-id":["10.1002\/wjs.12510"],"URL":"https:\/\/doi.org\/10.1002\/wjs.12510","archive":["Portico"],"relation":{},"ISSN":["0364-2313","1432-2323"],"issn-type":[{"value":"0364-2313","type":"print"},{"value":"1432-2323","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,2,19]]}}}