{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T15:36:49Z","timestamp":1761061009827,"version":"3.37.3"},"reference-count":38,"publisher":"Springer Science and Business Media LLC","issue":"8","license":[{"start":{"date-parts":[[2020,4,2]],"date-time":"2020-04-02T00:00:00Z","timestamp":1585785600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"},{"start":{"date-parts":[[2020,4,2]],"date-time":"2020-04-02T00:00:00Z","timestamp":1585785600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"funder":[{"DOI":"10.13039\/501100003725","name":"National Research Foundation of Korea","doi-asserted-by":"crossref","award":["NRF-2019R1A2C1002118"],"award-info":[{"award-number":["NRF-2019R1A2C1002118"]}],"id":[{"id":"10.13039\/501100003725","id-type":"DOI","asserted-by":"crossref"}]},{"DOI":"10.13039\/100016275","name":"Seoul National University Bundang Hospital","doi-asserted-by":"crossref","award":["02-2017-035"],"award-info":[{"award-number":["02-2017-035"]}],"id":[{"id":"10.13039\/100016275","id-type":"DOI","asserted-by":"crossref"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Eur Radiol"],"published-print":{"date-parts":[[2020,8]]},"DOI":"10.1007\/s00330-020-06811-y","type":"journal-article","created":{"date-parts":[[2020,4,2]],"date-time":"2020-04-02T17:03:11Z","timestamp":1585846991000},"page":"4573-4585","update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Diagnostic sensitivity and specificity of 2-mSv CT vs. conventional-dose CT in adolescents and young adults with suspected appendicitis: post hoc subgroup analysis of the LOCAT data"],"prefix":"10.1007","volume":"30","author":[{"name":"for LOCAT Group","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Yousun","family":"Ko","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Woo Joo","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji Hoon","family":"Park","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hae Young","family":"Kim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ji Ye","family":"Sim","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Penampai","family":"Tannaphai","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Kyoung Ho","family":"Lee","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"297","published-online":{"date-parts":[[2020,4,2]]},"reference":[{"key":"6811_CR1","doi-asserted-by":"publisher","first-page":"1596","DOI":"10.1056\/NEJMoa1110734","volume":"366","author":"K Kim","year":"2012","unstructured":"Kim K, Kim YH, Kim SY et al (2012) Low-dose abdominal CT for evaluating suspected appendicitis. N Engl J Med 366:1596\u20131605","journal-title":"N Engl J Med"},{"key":"6811_CR2","doi-asserted-by":"publisher","first-page":"793","DOI":"10.1016\/S2468-1253(17)30247-9","volume":"2","author":"LOCAT Group","year":"2017","unstructured":"LOCAT Group (2017) Low-dose CT for the diagnosis of appendicitis in adolescents and young adults (LOCAT): a pragmatic, multicentre, randomised controlled non-inferiority trial. Lancet Gastroenterol Hepatol 2:793\u2013804","journal-title":"Lancet Gastroenterol Hepatol"},{"key":"6811_CR3","doi-asserted-by":"publisher","first-page":"71","DOI":"10.1016\/j.ijsu.2016.05.060","volume":"31","author":"NE Aly","year":"2016","unstructured":"Aly NE, McAteer D, Aly EH (2016) Low vs. standard dose computed tomography in suspected acute appendicitis: is it time for a change? Int J Surg 31:71\u201379","journal-title":"Int J Surg"},{"key":"6811_CR4","doi-asserted-by":"publisher","first-page":"2537","DOI":"10.1007\/s00330-017-5231-z","volume":"28","author":"HM Yoon","year":"2018","unstructured":"Yoon HM, Suh CH, Cho YA et al (2018) The diagnostic performance of reduced-dose CT for suspected appendicitis in paediatric and adult patients: a systematic review and diagnostic meta-analysis. Eur Radiol 28:2537\u20132548","journal-title":"Eur Radiol"},{"key":"6811_CR5","doi-asserted-by":"publisher","first-page":"W198","DOI":"10.2214\/AJR.16.17274","volume":"208","author":"SJ Yun","year":"2017","unstructured":"Yun SJ, Ryu CW, Choi NY, Kim HC, Oh JY, Yang DM (2017) Comparison of low- and standard-dose CT for the diagnosis of acute appendicitis: a meta-analysis. AJR Am J Roentgenol 208:W198\u2013W207","journal-title":"AJR Am J Roentgenol"},{"key":"6811_CR6","doi-asserted-by":"publisher","unstructured":"Rud B, Vejborg TS, Rappeport ED, Reitsma JB, Wille-Jorgensen P (2019) Computed tomography for diagnosis of acute appendicitis in adults. Cochrane Database Syst Rev. https:\/\/doi.org\/10.1002\/14651858.CD14009977.pub2","DOI":"10.1002\/14651858.CD14009977.pub2"},{"key":"6811_CR7","doi-asserted-by":"publisher","first-page":"1308","DOI":"10.3346\/jkms.2014.29.9.1308","volume":"29","author":"Park JH, for LOCAT Group","year":"2014","unstructured":"Park JH, for LOCAT Group (2014) Diagnostic imaging utilization in cases of acute appendicitis: multi-center experience. J Korean Med Sci 29:1308\u20131316","journal-title":"J Korean Med Sci"},{"key":"6811_CR8","doi-asserted-by":"crossref","unstructured":"Kim HJ, Lee KH, Kim MJ, Park SB, Ko Y (2020) Using 2-mSv appendiceal CT in usual practice for adolescents and young adults: willingness survey of 579 radiologists, emergency physicians, and surgeons from 20 hospitals. Korean J Radiol 21:68\u201376","DOI":"10.3348\/kjr.2019.0010"},{"key":"6811_CR9","doi-asserted-by":"publisher","first-page":"176","DOI":"10.1016\/S0140-6736(05)17709-5","volume":"365","author":"PM Rothwell","year":"2005","unstructured":"Rothwell PM (2005) Subgroup analysis in randomised controlled trials: importance, indications, and interpretation. Lancet 365:176\u2013186","journal-title":"Lancet"},{"key":"6811_CR10","doi-asserted-by":"publisher","first-page":"W163","DOI":"10.7326\/0003-4819-147-8-200710160-00010-w1","volume":"147","author":"JP Vandenbroucke","year":"2007","unstructured":"Vandenbroucke JP, von Elm E, Altman DG et al (2007) Strengthening the reporting of observational studies in epidemiology (STROBE): explanation and elaboration. Ann Intern Med 147:W163\u2013W194","journal-title":"Ann Intern Med"},{"key":"6811_CR11","first-page":"33","volume":"3","author":"TJ VanderWeele","year":"2014","unstructured":"VanderWeele TJ, Knol MJ (2014) A tutorial on interaction. Epidemiol Methods 3:33\u201372","journal-title":"Epidemiol Methods"},{"key":"6811_CR12","doi-asserted-by":"publisher","first-page":"1616","DOI":"10.1016\/S0140-6736(95)90120-5","volume":"345","author":"PM Rothwell","year":"1995","unstructured":"Rothwell PM (1995) Can overall results of clinical trials be applied to all patients? Lancet 345:1616\u20131619","journal-title":"Lancet"},{"key":"6811_CR13","doi-asserted-by":"publisher","first-page":"28","DOI":"10.1186\/1745-6215-15-28","volume":"15","author":"Ahn S, LOCAT Group","year":"2014","unstructured":"Ahn S, LOCAT Group (2014) LOCAT (low-dose computed tomography for appendicitis trial) comparing clinical outcomes following low- vs standard-dose computed tomography as the first-line imaging test in adolescents and young adults with suspected acute appendicitis: study protocol for a randomized controlled trial. Trials 15:28","journal-title":"Trials"},{"key":"6811_CR14","first-page":"264","volume":"58","author":"V Velanovich","year":"1992","unstructured":"Velanovich V, Satava R (1992) Balancing the normal appendectomy rate with the perforated appendicitis rate: implications for quality assurance. Am Surg 58:264\u2013269","journal-title":"Am Surg"},{"key":"6811_CR15","doi-asserted-by":"publisher","first-page":"1278","DOI":"10.1016\/S0140-6736(15)00275-5","volume":"386","author":"A Bhangu","year":"2015","unstructured":"Bhangu A, S\u00f8reide K, Di Saverio S, Assarsson JH, Drake FT (2015) Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management. Lancet 386:1278\u20131287","journal-title":"Lancet"},{"key":"6811_CR16","doi-asserted-by":"publisher","first-page":"107","DOI":"10.1136\/bmj.308.6921.107","volume":"308","author":"R Andersson","year":"1994","unstructured":"Andersson R, Hugander A, Thulin A, Nystrom PO, Olaison G (1994) Indications for operation in suspected appendicitis and incidence of perforation. BMJ 308:107\u2013110","journal-title":"BMJ"},{"key":"6811_CR17","doi-asserted-by":"publisher","first-page":"88","DOI":"10.4174\/astr.2017.93.2.88","volume":"93","author":"HJ Kim","year":"2017","unstructured":"Kim HJ, Kim MS, Park JH et al (2017) Meaningful standard of reference for appendiceal perforation: pathology, surgery, or both? Ann Surg Treat Res 93:88\u201397","journal-title":"Ann Surg Treat Res"},{"key":"6811_CR18","doi-asserted-by":"publisher","first-page":"454","DOI":"10.1056\/NEJMra1510059","volume":"375","author":"I Ford","year":"2016","unstructured":"Ford I, Norrie J (2016) Pragmatic trials. N Engl J Med 375:454\u2013463","journal-title":"N Engl J Med"},{"key":"6811_CR19","doi-asserted-by":"publisher","first-page":"1453","DOI":"10.1016\/S0140-6736(07)61602-X","volume":"370","author":"E von Elm","year":"2007","unstructured":"von Elm E, Altman DG, Egger M, Pocock SJ, Gotzsche PC, Vandenbroucke JP (2007) The strengthening the reporting of observational studies in epidemiology (STROBE) statement: guidelines for reporting observational studies. Lancet 370:1453\u20131457","journal-title":"Lancet"},{"key":"6811_CR20","doi-asserted-by":"publisher","first-page":"826","DOI":"10.1148\/radiol.2015151516","volume":"277","author":"PM Bossuyt","year":"2015","unstructured":"Bossuyt PM, Reitsma JB, Bruns DE et al (2015) STARD 2015: an updated list of essential items for reporting diagnostic accuracy studies. Radiology 277:826\u2013832","journal-title":"Radiology"},{"key":"6811_CR21","doi-asserted-by":"publisher","first-page":"2189","DOI":"10.1056\/NEJMsr077003","volume":"357","author":"R Wang","year":"2007","unstructured":"Wang R, Lagakos SW, Ware JH, Hunter DJ, Drazen JM (2007) Statistics in medicine\u2014reporting of subgroup analyses in clinical trials. N Engl J Med 357:2189\u20132194","journal-title":"N Engl J Med"},{"key":"6811_CR22","doi-asserted-by":"publisher","first-page":"507","DOI":"10.1148\/radiol.2015141520","volume":"276","author":"K MacGregor","year":"2015","unstructured":"MacGregor K, Li I, Dowdell T, Gray BG (2015) Identifying institutional diagnostic reference levels for CT with radiation dose index monitoring software. Radiology 276:507\u2013517","journal-title":"Radiology"},{"key":"6811_CR23","doi-asserted-by":"publisher","first-page":"246","DOI":"10.3348\/kjr.2018.0109","volume":"20","author":"SB Park","year":"2019","unstructured":"Park SB, Kim MJ, Ko Y, Sim JY, Kim HJ, Lee KH (2019) Structured reporting versus free-text reporting for appendiceal computed tomography in adolescents and young adults: preference survey of 594 referring physicians, surgeons, and radiologists from 20 hospitals. Korean J Radiol 20:246\u2013255","journal-title":"Korean J Radiol"},{"key":"6811_CR24","doi-asserted-by":"publisher","first-page":"W594","DOI":"10.2214\/AJR.15.14513","volume":"205","author":"HK Yang","year":"2015","unstructured":"Yang HK, Ko Y, Lee MH et al (2015) Initial performance of radiologists and radiology residents in interpreting low-dose (2-mSv) appendiceal CT. AJR Am J Roentgenol 205:W594\u2013W611","journal-title":"AJR Am J Roentgenol"},{"key":"6811_CR25","doi-asserted-by":"publisher","first-page":"1813","DOI":"10.2214\/ajr.184.6.01841813","volume":"184","author":"CP Daly","year":"2005","unstructured":"Daly CP, Cohan RH, Francis IR, Caoili EM, Ellis JH, Nan B (2005) Incidence of acute appendicitis in patients with equivocal CT findings. AJR Am J Roentgenol 184:1813\u20131820","journal-title":"AJR Am J Roentgenol"},{"key":"6811_CR26","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 (1986) A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med 15:557\u2013564","journal-title":"Ann Emerg Med"},{"key":"6811_CR27","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 (2008) The appendicitis inflammatory response score: a tool for the diagnosis of acute appendicitis that outperforms the Alvarado score. World J Surg 32:1843\u20131849","journal-title":"World J Surg"},{"key":"6811_CR28","doi-asserted-by":"publisher","first-page":"899","DOI":"10.1177\/0284185114542297","volume":"56","author":"SH Kim","year":"2015","unstructured":"Kim SH, Yoon JH, Lee JH et al (2015) Low-dose CT for patients with clinically suspected acute appendicitis: optimal strength of sinogram affirmed iterative reconstruction for image quality and diagnostic performance. Acta Radiol 56:899\u2013907","journal-title":"Acta Radiol"},{"key":"6811_CR29","doi-asserted-by":"publisher","first-page":"1697","DOI":"10.1200\/JCO.2014.59.8862","volume":"33","author":"S Zhang","year":"2015","unstructured":"Zhang S, Liang F, Li W, Hu X (2015) Subgroup analyses in reporting of phase III clinical trials in solid tumors. J Clin Oncol 33:1697\u20131702","journal-title":"J Clin Oncol"},{"key":"6811_CR30","doi-asserted-by":"publisher","first-page":"575","DOI":"10.1007\/s10654-005-7835-x","volume":"20","author":"T Andersson","year":"2005","unstructured":"Andersson T, Alfredsson L, Kallberg H, Zdravkovic S, Ahlbom A (2005) Calculating measures of biological interaction. Eur J Epidemiol 20:575\u2013579","journal-title":"Eur J Epidemiol"},{"key":"6811_CR31","doi-asserted-by":"publisher","first-page":"27","DOI":"10.1093\/biomet\/80.1.27","volume":"80","author":"D Firth","year":"1993","unstructured":"Firth D (1993) Bias reduction of maximum likelihood estimates. Biometrika 80:27\u201338","journal-title":"Biometrika"},{"key":"6811_CR32","doi-asserted-by":"publisher","first-page":"82","DOI":"10.1016\/S0140-6736(04)17670-8","volume":"365","author":"PM Rothwell","year":"2005","unstructured":"Rothwell PM (2005) External validity of randomised controlled trials: \u201cto whom do the results of this trial apply?\u201d. Lancet 365:82\u201393","journal-title":"Lancet"},{"key":"6811_CR33","doi-asserted-by":"publisher","first-page":"649","DOI":"10.1148\/radiol.2333031150","volume":"233","author":"MK Kalra","year":"2004","unstructured":"Kalra MK, Maher MM, Toth TL et al (2004) Techniques and applications of automatic tube current modulation for CT. Radiology 233:649\u2013657","journal-title":"Radiology"},{"key":"6811_CR34","doi-asserted-by":"publisher","first-page":"446","DOI":"10.1007\/s00330-008-1164-x","volume":"19","author":"A Platon","year":"2009","unstructured":"Platon A, Jlassi H, Rutschmann OT et al (2009) Evaluation of a low-dose CT protocol with oral contrast for assessment of acute appendicitis. Eur Radiol 19:446\u2013454","journal-title":"Eur Radiol"},{"key":"6811_CR35","doi-asserted-by":"publisher","first-page":"296","DOI":"10.1016\/j.clinimag.2013.12.014","volume":"38","author":"N Karabulut","year":"2014","unstructured":"Karabulut N, Kiroglu Y, Herek D, Kocak TB, Erdur B (2014) Feasibility of low-dose unenhanced multi-detector CT in patients with suspected acute appendicitis: comparison with sonography. Clin Imaging 38:296\u2013301","journal-title":"Clin Imaging"},{"key":"6811_CR36","doi-asserted-by":"publisher","first-page":"104","DOI":"10.1007\/s00268-014-2794-6","volume":"39","author":"D Kollar","year":"2015","unstructured":"Kollar D, McCartan DP, Bourke M, Cross KS, Dowdall J (2015) Predicting acute appendicitis? A comparison of the Alvarado score, the appendicitis inflammatory response score and clinical assessment. World J Surg 39:104\u2013109","journal-title":"World J Surg"},{"key":"6811_CR37","doi-asserted-by":"publisher","first-page":"563","DOI":"10.1002\/bjs.9773","volume":"102","author":"AJ Scott","year":"2015","unstructured":"Scott AJ, Mason SE, Arunakirinathan M, Reissis Y, Kinross JM, Smith JJ (2015) Risk stratification by the appendicitis inflammatory response score to guide decision-making in patients with suspected appendicitis. Br J Surg 102:563\u2013572","journal-title":"Br J Surg"},{"key":"6811_CR38","doi-asserted-by":"publisher","first-page":"218","DOI":"10.1016\/j.jamcollsurg.2014.10.010","volume":"220","author":"WJ Tan","year":"2015","unstructured":"Tan WJ, Acharyya S, Goh YC et al (2015) Prospective comparison of the Alvarado score and CT scan in the evaluation of suspected appendicitis: a proposed algorithm to guide CT use. J Am Coll Surg 220:218\u2013224","journal-title":"J Am Coll Surg"}],"container-title":["European Radiology"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00330-020-06811-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1007\/s00330-020-06811-y\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1007\/s00330-020-06811-y.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2021,4,1]],"date-time":"2021-04-01T23:30:20Z","timestamp":1617319820000},"score":1,"resource":{"primary":{"URL":"http:\/\/link.springer.com\/10.1007\/s00330-020-06811-y"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,4,2]]},"references-count":38,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2020,8]]}},"alternative-id":["6811"],"URL":"https:\/\/doi.org\/10.1007\/s00330-020-06811-y","relation":{},"ISSN":["0938-7994","1432-1084"],"issn-type":[{"type":"print","value":"0938-7994"},{"type":"electronic","value":"1432-1084"}],"subject":[],"published":{"date-parts":[[2020,4,2]]},"assertion":[{"value":"10 November 2019","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 March 2020","order":2,"name":"revised","label":"Revised","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"13 March 2020","order":3,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"2 April 2020","order":4,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}},{"order":1,"name":"Ethics","group":{"name":"EthicsHeading","label":"Compliance with ethical standards"}},{"value":"The scientific guarantor of this publication is Kyoung Ho Lee.","order":2,"name":"Ethics","group":{"name":"EthicsHeading","label":"Guarantor"}},{"value":"The authors of this manuscript declare relationships with the following companies: Kyoung Ho Lee received a research grant from the National Research Foundation of Korea and Seoul National University Bundang Hospital for the submitted work, and from Bracco Imaging Korea outside the submitted work. Yousun Ko received salary support from the research grants. Ji Hoon Park received a research grant from Bracco Imaging Korea outside the submitted work. Other authors declare there is no conflict of interest.","order":3,"name":"Ethics","group":{"name":"EthicsHeading","label":"Conflict of interest"}},{"value":"One of the authors\u00a0(Woo Joo Lee) has significant statistical expertise.","order":4,"name":"Ethics","group":{"name":"EthicsHeading","label":"Statistics and biometry"}},{"value":"Written informed consent was waived by the Institutional Review Board.","order":5,"name":"Ethics","group":{"name":"EthicsHeading","label":"Informed consent"}},{"value":"Institutional Review Board approval was obtained.","order":6,"name":"Ethics","group":{"name":"EthicsHeading","label":"Ethical approval"}},{"value":"Some study subjects or cohorts have been previously reported in Lancet Gastroenterol Hepatol (2017; 2: 793\u2013804).","order":7,"name":"Ethics","group":{"name":"EthicsHeading","label":"Study subjects or cohorts overlap"}},{"value":"\u2022 Retrospective\u2022 Diagnostic or prognostic study\u2022 Multicenter study","order":8,"name":"Ethics","group":{"name":"EthicsHeading","label":"Methodology"}}]}}