{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,9]],"date-time":"2026-04-09T19:09:48Z","timestamp":1775761788445,"version":"3.50.1"},"reference-count":42,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T00:00:00Z","timestamp":1679529600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"},{"start":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T00:00:00Z","timestamp":1679529600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/www.springernature.com\/gp\/researchers\/text-and-data-mining"}],"funder":[{"DOI":"10.13039\/501100004700","name":"Taipei Medical University","doi-asserted-by":"publisher","award":["TMU111-AE1-B07"],"award-info":[{"award-number":["TMU111-AE1-B07"]}],"id":[{"id":"10.13039\/501100004700","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["J Med Syst"],"DOI":"10.1007\/s10916-023-01932-5","type":"journal-article","created":{"date-parts":[[2023,3,23]],"date-time":"2023-03-23T09:03:13Z","timestamp":1679562193000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":15,"title":["Application of Artificial Neural Network Models to Differentiate Between Complicated and Uncomplicated Acute Appendicitis"],"prefix":"10.1007","volume":"47","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0661-173X","authenticated-orcid":false,"given":"Hui-An","family":"Lin","sequence":"first","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1707-3794","authenticated-orcid":false,"given":"Li-Tsung","family":"Lin","sequence":"additional","affiliation":[]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0470-2184","authenticated-orcid":false,"given":"Sheng-Feng","family":"Lin","sequence":"additional","affiliation":[]}],"member":"297","published-online":{"date-parts":[[2023,3,23]]},"reference":[{"key":"1932_CR1","unstructured":"DeFrances CJ, Golosinskiy A, Hall MJ, Schwartzman A, Williams SN. National hospital discharge survey; 2007 summary. 2010."},{"issue":"7266","key":"1932_CR2","doi-asserted-by":"publisher","first-page":"919","DOI":"10.1136\/bmj.321.7266.919","volume":"321","author":"CD Douglas","year":"2000","unstructured":"Douglas CD, Macpherson NE, Davidson PM, Gani JS. Randomised controlled trial of ultrasonography in diagnosis of acute appendicitis, incorporating the Alvarado score. Bmj. 2000;321(7266):919.","journal-title":"Bmj"},{"issue":"5","key":"1932_CR3","doi-asserted-by":"publisher","first-page":"557","DOI":"10.1016\/S0196-0644(86)80993-3","volume":"15","author":"A Alvarado","year":"1986","unstructured":"Alvarado A. A practical score for the early diagnosis of acute appendicitis. Annals of emergency medicine. 1986;15(5):557\u201364.","journal-title":"Annals of emergency medicine"},{"issue":"8","key":"1932_CR4","doi-asserted-by":"publisher","first-page":"1843","DOI":"10.1007\/s00268-008-9649-y","volume":"32","author":"M Andersson","year":"2008","unstructured":"Andersson M, Andersson RE. The appendicitis inflammatory response score: a tool for the diagnosis of acute appendicitis that outperforms the Alvarado score. World journal of surgery. 2008;32(8):1843\u20139.","journal-title":"World journal of surgery"},{"issue":"12","key":"1932_CR5","first-page":"894","volume":"24","author":"MQ Butt","year":"2014","unstructured":"Butt MQ, Chatha SS, Ghumman AQ, Farooq M. RIPASA score: a new diagnostic score for diagnosis of acute appendicitis. J Coll Physicians Surg Pak. 2014;24(12):894\u20137.","journal-title":"J Coll Physicians Surg Pak"},{"issue":"Suppl 2","key":"1932_CR6","first-page":"S559-65","volume":"23","author":"SY Park","year":"2015","unstructured":"Park SY, Kim SM. Acute appendicitis diagnosis using artificial neural networks. Technol Health Care. 2015;23 Suppl 2:S559-65.","journal-title":"Technol Health Care"},{"issue":"23","key":"1932_CR7","doi-asserted-by":"publisher","first-page":"2340","DOI":"10.1001\/jama.2015.6154","volume":"313","author":"P Salminen","year":"2015","unstructured":"Salminen P, Paajanen H, Rautio T, Nordstr\u00f6m P, Aarnio M, Rantanen T, et al. Antibiotic therapy vs appendectomy for treatment of uncomplicated acute appendicitis: the APPAC randomized clinical trial. Jama. 2015;313(23):2340\u20138.","journal-title":"Jama"},{"issue":"13","key":"1932_CR8","doi-asserted-by":"publisher","first-page":"1785","DOI":"10.1002\/bjs.10660","volume":"104","author":"H Park","year":"2017","unstructured":"Park H, Kim M, Lee B. Randomized clinical trial of antibiotic therapy for uncomplicated appendicitis. British Journal of Surgery. 2017;104(13):1785\u201390.","journal-title":"British Journal of Surgery"},{"issue":"12","key":"1932_CR9","doi-asserted-by":"publisher","first-page":"1259","DOI":"10.1001\/jama.2018.13201","volume":"320","author":"P Salminen","year":"2018","unstructured":"Salminen P, Tuominen R, Paajanen H, Rautio T, Nordstr\u00f6m P, Aarnio M, et al. Five-year follow-up of antibiotic therapy for uncomplicated acute appendicitis in the APPAC randomized clinical trial. Jama. 2018;320(12):1259\u201365.","journal-title":"Jama"},{"issue":"1","key":"1932_CR10","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1186\/s13017-020-00306-3","volume":"15","author":"S Di Saverio","year":"2020","unstructured":"Di Saverio S, Podda M, De Simone B, Ceresoli M, Augustin G, Gori A, et al. Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines. World J Emerg Surg. 2020;15(1):27.","journal-title":"World J Emerg Surg"},{"issue":"20","key":"1932_CR11","doi-asserted-by":"publisher","first-page":"1937","DOI":"10.1056\/NEJMcp1215006","volume":"372","author":"DR Flum","year":"2015","unstructured":"Flum DR. Acute appendicitis\u2014appendectomy or the \u201cantibiotics first\u201d strategy. New England Journal of Medicine. 2015;372(20):1937\u201343.","journal-title":"New England Journal of Medicine"},{"issue":"7","key":"1932_CR12","doi-asserted-by":"publisher","first-page":"1339","DOI":"10.1016\/j.jpedsurg.2017.09.012","volume":"53","author":"S Saluja","year":"2018","unstructured":"Saluja S, Sun T, Mao J, Steigman SA, Oh PS, Yeo HL, et al. Early versus late surgical management of complicated appendicitis in children: a statewide database analysis with one-year follow-up. Journal of Pediatric Surgery. 2018;53(7):1339\u201344.","journal-title":"Journal of Pediatric Surgery"},{"issue":"6","key":"1932_CR13","doi-asserted-by":"publisher","first-page":"1195","DOI":"10.1016\/j.amjsurg.2017.07.039","volume":"214","author":"TS Helling","year":"2017","unstructured":"Helling TS, Soltys DF, Seals S. Operative versus non-operative management in the care of patients with complicated appendicitis. The American Journal of Surgery. 2017;214(6):1195\u2013200.","journal-title":"The American Journal of Surgery"},{"issue":"4","key":"1932_CR14","doi-asserted-by":"publisher","first-page":"586","DOI":"10.1016\/j.amjsurg.2017.10.032","volume":"215","author":"KA Young","year":"2018","unstructured":"Young KA, Neuhaus NM, Fluck M, Blansfield JA, Hunsinger MA, Shabahang MM, et al. Outcomes of complicated appendicitis: is conservative management as smooth as it seems? The American Journal of Surgery. 2018;215(4):586\u201392.","journal-title":"The American Journal of Surgery"},{"issue":"1","key":"1932_CR15","doi-asserted-by":"publisher","first-page":"56","DOI":"10.14740\/jocmr3672","volume":"11","author":"P Gavriilidis","year":"2019","unstructured":"Gavriilidis P, De\u2019Angelis N, Katsanos K, Di Saverio S. Acute appendicectomy or conservative treatment for complicated appendicitis (phlegmon or abscess)? A systematic review by updated traditional and cumulative meta-analysis. Journal of clinical medicine research. 2019;11(1):56.","journal-title":"Journal of clinical medicine research"},{"issue":"1","key":"1932_CR16","doi-asserted-by":"publisher","first-page":"79","DOI":"10.1016\/j.jss.2011.09.049","volume":"176","author":"ME Br\u00f6ker","year":"2012","unstructured":"Br\u00f6ker ME, van Lieshout EM, van der Elst M, Stassen LP, Schepers T. Discriminating between simple and perforated appendicitis. Journal of Surgical Research. 2012;176(1):79\u201383.","journal-title":"Journal of Surgical Research"},{"issue":"1","key":"1932_CR17","doi-asserted-by":"publisher","first-page":"1","DOI":"10.1186\/s13017-016-0107-0","volume":"11","author":"Y Imaoka","year":"2016","unstructured":"Imaoka Y, Itamoto T, Takakura Y, Suzuki T, Ikeda S, Urushihara T. Validity of predictive factors of acute complicated appendicitis. World Journal of Emergency Surgery. 2016;11(1):1\u20135.","journal-title":"World Journal of Emergency Surgery"},{"key":"1932_CR18","doi-asserted-by":"crossref","unstructured":"Khan MS, Siddiqui MTH, Shahzad N, Haider A, Chaudhry MBH, Alvi R. Factors associated with complicated appendicitis: view from a low-middle income country. Cureus. 2019;11(5).","DOI":"10.7759\/cureus.4765"},{"issue":"5","key":"1932_CR19","doi-asserted-by":"publisher","first-page":"192","DOI":"10.3393\/ac.2015.31.5.192","volume":"31","author":"TH Kim","year":"2015","unstructured":"Kim TH, Cho BS, Jung JH, Lee MS, Jang JH, Kim CN. Predictive factors to distinguish between patients with noncomplicated appendicitis and those with complicated appendicitis. Annals of coloproctology. 2015;31(5):192.","journal-title":"Annals of coloproctology"},{"key":"1932_CR20","doi-asserted-by":"crossref","unstructured":"Kang C-B, Li W-Q, Zheng J-W, Li X-W, Lin D-P, Chen X-F, et al. Preoperative assessment of complicated appendicitis through stress reaction and clinical manifestations. Medicine. 2019;98(23).","DOI":"10.1097\/MD.0000000000015768"},{"issue":"8","key":"1932_CR21","doi-asserted-by":"publisher","first-page":"979","DOI":"10.1002\/bjs.9835","volume":"102","author":"JJ Atema","year":"2015","unstructured":"Atema JJ, van Rossem CC, Leeuwenburgh MM, Stoker J, Boermeester MA. Scoring system to distinguish uncomplicated from complicated acute appendicitis. Journal of British Surgery. 2015;102(8):979\u201390.","journal-title":"Journal of British Surgery"},{"issue":"9","key":"1932_CR22","doi-asserted-by":"publisher","first-page":"3601","DOI":"10.1007\/s00330-018-5339-9","volume":"28","author":"M Avanesov","year":"2018","unstructured":"Avanesov M, Wiese NJ, Karul M, Guerreiro H, Keller S, Busch P, et al. Diagnostic prediction of complicated appendicitis by combined clinical and radiological appendicitis severity index (APSI). European radiology. 2018;28(9):3601\u201310.","journal-title":"European radiology"},{"issue":"3","key":"1932_CR23","doi-asserted-by":"publisher","first-page":"948","DOI":"10.1007\/s00261-020-02737-7","volume":"46","author":"HY Kim","year":"2021","unstructured":"Kim HY, Park JH, Lee SS, Jeon J-J, Yoon CJ, Lee KH. Differentiation between complicated and uncomplicated appendicitis: diagnostic model development and validation study. Abdominal Radiology. 2021;46(3):948\u201359.","journal-title":"Abdominal Radiology"},{"issue":"1","key":"1932_CR24","doi-asserted-by":"publisher","first-page":"52","DOI":"10.1186\/s13017-021-00398-5","volume":"16","author":"HA Lin","year":"2021","unstructured":"Lin HA, Tsai HW, Chao CC, Lin SF. Periappendiceal fat-stranding models for discriminating between complicated and uncomplicated acute appendicitis: a diagnostic and validation study. World J Emerg Surg. 2021;16(1):52.","journal-title":"World J Emerg Surg"},{"issue":"6088","key":"1932_CR25","doi-asserted-by":"publisher","first-page":"533","DOI":"10.1038\/323533a0","volume":"323","author":"DE Rumelhart","year":"1986","unstructured":"Rumelhart DE, Hinton GE, Williams RJ. Learning representations by back-propagating errors. Nature. 1986;323(6088):533\u20136.","journal-title":"Nature"},{"key":"1932_CR26","doi-asserted-by":"publisher","first-page":"74","DOI":"10.1016\/j.jbi.2016.08.004","volume":"63","author":"F Gorunescu","year":"2016","unstructured":"Gorunescu F, Belciug S. Boosting backpropagation algorithm by stimulus-sampling: Application in computer-aided medical diagnosis. J Biomed Inform. 2016;63:74\u201381.","journal-title":"J Biomed Inform"},{"issue":"12","key":"1932_CR27","doi-asserted-by":"publisher","first-page":"e0189369","DOI":"10.1371\/journal.pone.0189369","volume":"12","author":"W Castro","year":"2017","unstructured":"Castro W, Oblitas J, Santa-Cruz R, Avila-George H. Multilayer perceptron architecture optimization using parallel computing techniques. PLoS One. 2017;12(12):e0189369.","journal-title":"PLoS One"},{"issue":"2","key":"1932_CR28","doi-asserted-by":"publisher","first-page":"244","DOI":"10.1016\/j.injury.2019.01.007","volume":"50","author":"S Hassanipour","year":"2019","unstructured":"Hassanipour S, Ghaem H, Arab-Zozani M, Seif M, Fararouei M, Abdzadeh E, et al. Comparison of artificial neural network and logistic regression models for prediction of outcomes in trauma patients: A systematic review and meta-analysis. Injury. 2019;50(2):244\u201350.","journal-title":"Injury"},{"issue":"5\u20136","key":"1932_CR29","doi-asserted-by":"publisher","first-page":"352","DOI":"10.1016\/S1532-0464(03)00034-0","volume":"35","author":"S Dreiseitl","year":"2002","unstructured":"Dreiseitl S, Ohno-Machado L. Logistic regression and artificial neural network classification models: a methodology review. J Biomed Inform. 2002;35(5\u20136):352\u20139.","journal-title":"J Biomed Inform"},{"issue":"1","key":"1932_CR30","doi-asserted-by":"publisher","first-page":"50","DOI":"10.1186\/s13017-021-00394-9","volume":"16","author":"A Litvin","year":"2021","unstructured":"Litvin A, Korenev S, Rumovskaya S, Sartelli M, Baiocchi G, Biffl WL, et al. WSES project on decision support systems based on artificial neural networks in emergency surgery. World J Emerg Surg. 2021;16(1):50.","journal-title":"World J Emerg Surg"},{"issue":"9","key":"1932_CR31","doi-asserted-by":"publisher","first-page":"e0222030","DOI":"10.1371\/journal.pone.0222030","volume":"14","author":"J Reismann","year":"2019","unstructured":"Reismann J, Romualdi A, Kiss N, Minderjahn MI, Kallarackal J, Schad M, et al. Diagnosis and classification of pediatric acute appendicitis by artificial intelligence methods: An investigator-independent approach. PLoS One. 2019;14(9):e0222030.","journal-title":"PLoS One"},{"issue":"12","key":"1932_CR32","doi-asserted-by":"publisher","first-page":"e1075-e81","DOI":"10.1097\/PEC.0000000000001904","volume":"37","author":"F Akg\u00fcl","year":"2021","unstructured":"Akg\u00fcl F, Er A, Ulusoy E, \u00c7a\u011flar A, \u00c7itlenbik H, Keskino\u011flu P, et al. Integration of Physical Examination, Old and New Biomarkers, and Ultrasonography by Using Neural Networks for Pediatric Appendicitis. Pediatr Emerg Care. 2021;37(12):e1075-e81.","journal-title":"Pediatr Emerg Care"},{"key":"1932_CR33","doi-asserted-by":"crossref","unstructured":"Podda M, Andersson R, Boermeester M, Coccolini F, Sartelli M, Moore EE, et al. Do young patients with high clinical suspicion of appendicitis really need cross-sectional imaging? Proceedings from a highly controversial debate among the experts\u2019 panel of 2020 WSES Jerusalem guidelines. J Trauma Acute Care Surg. 2021;90(5):e101-e7.","DOI":"10.1097\/TA.0000000000003097"},{"issue":"22","key":"1932_CR34","doi-asserted-by":"publisher","first-page":"e20512","DOI":"10.1097\/MD.0000000000020512","volume":"99","author":"H-A Lin","year":"2020","unstructured":"Lin H-A, Lin S-F. Factors associated with fat stranding on computed tomography in acute appendicitis. Medicine. 2020;99(22):e20512.","journal-title":"Medicine"},{"key":"1932_CR35","doi-asserted-by":"publisher","first-page":"g7594","DOI":"10.1136\/bmj.g7594","volume":"350","author":"GS Collins","year":"2015","unstructured":"Collins GS, Reitsma JB, Altman DG, Moons KG. Transparent reporting of a multivariable prediction model for individual prognosis or diagnosis (TRIPOD): the TRIPOD statement. BMJ. 2015;350:g7594.","journal-title":"BMJ"},{"issue":"12","key":"1932_CR36","doi-asserted-by":"publisher","first-page":"2673","DOI":"10.1162\/089976601317098484","volume":"13","author":"LS Camargo","year":"2001","unstructured":"Camargo LS, Yoneyama T. Specification of training sets and the number of hidden neurons for multilayer perceptrons. Neural Comput. 2001;13(12):2673\u201380.","journal-title":"Neural Comput"},{"issue":"5","key":"1932_CR37","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v028.i05","volume":"28","author":"M Kuhn","year":"2008","unstructured":"Kuhn M. Building Predictive Models in R Using the caret Package. Journal of Statistical Software. 2008;28(5):1\u201326.","journal-title":"Journal of Statistical Software"},{"issue":"11","key":"1932_CR38","doi-asserted-by":"publisher","first-page":"1","DOI":"10.18637\/jss.v085.i11","volume":"85","author":"MW Beck","year":"2018","unstructured":"Beck MW. NeuralNetTools: Visualization and Analysis Tools for Neural Networks. J Stat Softw. 2018;85(11):1\u201320.","journal-title":"J Stat Softw"},{"issue":"2","key":"1932_CR39","doi-asserted-by":"publisher","first-page":"122","DOI":"10.7326\/M13-1522","volume":"160","author":"MJ Leening","year":"2014","unstructured":"Leening MJ, Vedder MM, Witteman JC, Pencina MJ, Steyerberg EW. Net reclassification improvement: computation, interpretation, and controversies: a literature review and clinician\u2019s guide. Annals of internal medicine. 2014;160(2):122\u201331.","journal-title":"Annals of internal medicine"},{"key":"1932_CR40","doi-asserted-by":"crossref","unstructured":"Cook NR. Comments on\u2019Evaluating the added predictive ability of a new marker: From area under the ROC curve to reclassification and beyond\u2019by MJ Pencina et al., Statistics in Medicine. Statistics in medicine. 2008;27(2):191-5.","DOI":"10.1002\/sim.2987"},{"issue":"3","key":"1932_CR41","doi-asserted-by":"publisher","first-page":"703","DOI":"10.1148\/rg.243035084","volume":"24","author":"JM Pereira","year":"2004","unstructured":"Pereira JM, Sirlin CB, Pinto PS, Jeffrey RB, Stella DL, Casola G. Disproportionate fat stranding: a helpful CT sign in patients with acute abdominal pain. Radiographics. 2004;24(3):703\u201315.","journal-title":"Radiographics"},{"issue":"1","key":"1932_CR42","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1148\/radiol.2017171260","volume":"287","author":"HY Kim","year":"2018","unstructured":"Kim HY, Park JH, Lee YJ, Lee SS, Jeon J-J, Lee KH. Systematic review and meta-analysis of CT features for differentiating complicated and uncomplicated appendicitis. Radiology. 2018;287(1):104\u201315.","journal-title":"Radiology"}],"container-title":["Journal of Medical Systems"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10916-023-01932-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/article\/10.1007\/s10916-023-01932-5\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1007\/s10916-023-01932-5.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,29]],"date-time":"2023-12-29T17:04:15Z","timestamp":1703869455000},"score":1,"resource":{"primary":{"URL":"https:\/\/link.springer.com\/10.1007\/s10916-023-01932-5"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,3,23]]},"references-count":42,"journal-issue":{"issue":"1","published-online":{"date-parts":[[2023,12]]}},"alternative-id":["1932"],"URL":"https:\/\/doi.org\/10.1007\/s10916-023-01932-5","relation":{},"ISSN":["1573-689X"],"issn-type":[{"value":"1573-689X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,3,23]]},"assertion":[{"value":"7 December 2022","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"27 February 2023","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"23 March 2023","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The authors declare that they have no competing interests.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Competing Interests"}},{"value":"This study was approved by the Joint Institutional Review Board (IRB) of Taipei Medical University (reference number: N201905057). The requirement of informed consent was waived by the IRB because the data used were anonymous and deidentified. This study was performed in accordance with the Declaration of Helsinki.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical Approval and Consent to Participate"}},{"value":"Not applicable.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Consent for Publication"}}],"article-number":"38"}}