{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,12]],"date-time":"2026-01-12T23:48:12Z","timestamp":1768261692984,"version":"3.49.0"},"reference-count":56,"publisher":"Elsevier BV","license":[{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/tdm\/userlicense\/1.0\/"},{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/www.elsevier.com\/legal\/tdmrep-license"},{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-017"},{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-037"},{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-012"},{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-029"},{"start":{"date-parts":[[2022,12,1]],"date-time":"2022-12-01T00:00:00Z","timestamp":1669852800000},"content-version":"stm-asf","delay-in-days":0,"URL":"https:\/\/doi.org\/10.15223\/policy-004"}],"funder":[{"DOI":"10.13039\/501100006306","name":"Sigrid Jus\u00e9liuksen S\u00e4\u00e4ti\u00f6","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006306","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["clinicalkey.com","clinicalkey.com.au","clinicalkey.es","clinicalkey.fr","clinicalkey.jp","elsevier.com","sciencedirect.com"],"crossmark-restriction":true},"short-container-title":["Contemporary Clinical Trials"],"published-print":{"date-parts":[[2022,12]]},"DOI":"10.1016\/j.cct.2022.106970","type":"journal-article","created":{"date-parts":[[2022,10,21]],"date-time":"2022-10-21T23:37:54Z","timestamp":1666395474000},"page":"106970","update-policy":"https:\/\/doi.org\/10.1016\/elsevier_cm_policy","source":"Crossref","is-referenced-by-count":5,"special_numbering":"C","title":["A randomized, controlled multicenter feasibility pilot trial on imaging confirmed uncomplicated acute appendicitis: Appendectomy vs. symptomatic treatment in pediatric patients (the APPSYPP) trial study protocol"],"prefix":"10.1016","volume":"123","author":[{"given":"Jenny","family":"Puputti","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Janne S.","family":"Suominen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Topi","family":"Luoto","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Pauliina","family":"Hiltunen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Liisi","family":"Ripatti","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Marianna","family":"Nikoskelainen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanna","family":"Nuutinen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Juha-Jaakko","family":"Sinikumpu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Esko","family":"Tahkola","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Susanna","family":"Porela-Tiihonen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Saija","family":"Hurme","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paulina","family":"Salminen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Mikko P.","family":"Pakarinen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"78","reference":[{"key":"10.1016\/j.cct.2022.106970_bb0005","doi-asserted-by":"crossref","first-page":"33","DOI":"10.1016\/j.jss.2018.06.010","article-title":"Occurrence and treatment of pediatric appendicitis in Finland 2004-2014","volume":"232","author":"Rautava","year":"2018","journal-title":"J. Surg. Res."},{"key":"10.1016\/j.cct.2022.106970_bb0010","doi-asserted-by":"crossref","first-page":"1336","DOI":"10.1002\/bjs.6736","article-title":"Genetic and environmental influences on the risk of acute appendicitis in twins","volume":"96","author":"Sadr Azodi","year":"2009","journal-title":"Br. J. Surg."},{"key":"10.1016\/j.cct.2022.106970_bb0015","doi-asserted-by":"crossref","first-page":"46","DOI":"10.1016\/S1092-9134(00)90011-X","article-title":"The pathology of acute appendicitis","volume":"4","author":"Carr","year":"2000","journal-title":"Ann. Diagn. Pathol."},{"key":"10.1016\/j.cct.2022.106970_bb0020","doi-asserted-by":"crossref","first-page":"1278","DOI":"10.1016\/S0140-6736(15)00275-5","article-title":"Acute appendicitis: modern understanding of pathogenesis, diagnosis, and management","volume":"386","author":"Bhangu","year":"2015","journal-title":"Lancet"},{"key":"10.1016\/j.cct.2022.106970_bb0025","first-page":"146","article-title":"Epidemiological similarities between appendicitis and diverticulitis suggesting a common underlying pathogenesis","author":"Livingston","year":"2011","journal-title":"Arch. Surg."},{"key":"10.1016\/j.cct.2022.106970_bb0030","doi-asserted-by":"crossref","first-page":"886","DOI":"10.1097\/01.sla.0000256391.05233.aa","article-title":"Disconnect between incidence of nonperforated and perforated appendicitis: implications for pathophysiology and management","volume":"245","author":"Livingston","year":"2007","journal-title":"Ann. Surg."},{"key":"10.1016\/j.cct.2022.106970_bb0035","doi-asserted-by":"crossref","first-page":"1785","DOI":"10.1002\/bjs.10660","article-title":"Randomized clinical trial of antibiotic therapy for uncomplicated appendicitis","volume":"104","author":"Park","year":"2017","journal-title":"Br. J. Surg."},{"key":"10.1016\/j.cct.2022.106970_bb0040","first-page":"313","article-title":"Antibiotic therapy vs appendectomy for treatment of uncomplicated acute appendicitis: the APPAC randomized clinical trial","author":"Salminen","year":"2015","journal-title":"JAMA - J. Am. Med. Assoc."},{"key":"10.1016\/j.cct.2022.106970_bb0045","first-page":"325","article-title":"Effect of oral moxifloxacin vs intravenous Ertapenem plus oral levofloxacin for treatment of uncomplicated acute appendicitis: the APPAC II randomized clinical trial","author":"Sippola","year":"2021","journal-title":"JAMA-J. Am. Med. Assoc."},{"key":"10.1016\/j.cct.2022.106970_bb0050","first-page":"384","article-title":"A randomized trial comparing antibiotics with appendectomy for appendicitis","year":"2021","journal-title":"N. Engl. J. Med."},{"key":"10.1016\/j.cct.2022.106970_bb0055","first-page":"377","article-title":"Amoxicillin plus clavulanic acid versus appendicectomy for treatment of acute uncomplicated appendicitis: an open-label, non-inferiority, randomised controlled trial","author":"Vons","year":"2011","journal-title":"Lancet"},{"key":"10.1016\/j.cct.2022.106970_bb0060","doi-asserted-by":"crossref","first-page":"215","DOI":"10.1016\/j.surg.2021.02.066","article-title":"Prognosis of ultrasonographic low-grade pediatric appendicitis treated with supportive care","volume":"170","author":"Wang","year":"2021","journal-title":"Surgery"},{"key":"10.1016\/j.cct.2022.106970_bb0065","doi-asserted-by":"crossref","first-page":"129","DOI":"10.4240\/wjgs.v12.i4.129","article-title":"Management of complicated acute appendicitis in children: still an existing controversy","volume":"12","author":"Zavras","year":"2020","journal-title":"World J. Gastrointest Surg."},{"key":"10.1016\/j.cct.2022.106970_bb0070","first-page":"31","article-title":"Complicated appendicitis and considerations for interval appendectomy","author":"Perez","year":"2018","journal-title":"J. Am. Acad. Phys. Assist."},{"key":"10.1016\/j.cct.2022.106970_bb0075","doi-asserted-by":"crossref","first-page":"1982","DOI":"10.1016\/j.ajem.2017.06.049","article-title":"Predictive factors of complicated appendicitis in children","volume":"35","author":"Zouari","year":"2017","journal-title":"Am. J. Emerg. Med."},{"key":"10.1016\/j.cct.2022.106970_bb0080","doi-asserted-by":"crossref","first-page":"2264","DOI":"10.1016\/j.jpedsurg.2012.09.019","article-title":"National trends in approach and outcomes with appendicitis in children","volume":"47","author":"Gasior","year":"2012","journal-title":"J. Pediatr. Surg."},{"key":"10.1016\/j.cct.2022.106970_bb0085","doi-asserted-by":"crossref","first-page":"404","DOI":"10.1053\/j.sempedsurg.2016.10.002","article-title":"Complications in common general pediatric surgery procedures","volume":"25","author":"Linnaus","year":"2016","journal-title":"Semin. Pediatr. Surg."},{"key":"10.1016\/j.cct.2022.106970_bb0090","doi-asserted-by":"crossref","first-page":"1794","DOI":"10.1016\/j.jpedsurg.2018.10.106","article-title":"The impact of pathological criteria on pediatric negative appendectomy rate","volume":"54","author":"Maloney","year":"2019","journal-title":"J. Pediatr. Surg."},{"key":"10.1016\/j.cct.2022.106970_bb0095","doi-asserted-by":"crossref","first-page":"1259","DOI":"10.1001\/jama.2018.13201","article-title":"Five-year follow-up of antibiotic therapy for uncomplicated acute appendicitis in the APPAC randomized clinical trial","volume":"320","author":"Salminen","year":"2018","journal-title":"JAMA"},{"key":"10.1016\/j.cct.2022.106970_bb0100","doi-asserted-by":"crossref","first-page":"67","DOI":"10.1097\/SLA.0000000000000835","article-title":"Nonoperative treatment with antibiotics versus surgery for acute nonperforated appendicitis in children: a pilot randomized controlled trial","volume":"261","author":"Svensson","year":"2015","journal-title":"Ann. Surg."},{"key":"10.1016\/j.cct.2022.106970_bb0105","first-page":"139","article-title":"Efficacy and safety of nonoperative treatment for acute appendicitis: a meta-analysis","author":"Georgiou","year":"2017","journal-title":"Pediatrics"},{"key":"10.1016\/j.cct.2022.106970_bb0110","first-page":"171","article-title":"Comparison of antibiotic therapy and appendectomy for acute uncomplicated appendicitis in children a meta-analysis","author":"Huang","year":"2017","journal-title":"JAMA Pediatr."},{"key":"10.1016\/j.cct.2022.106970_bb0115","first-page":"8","article-title":"Comparison of conservative treatment with appendectomy for acute uncomplicated pediatric appendicitis: a meta-analysis","author":"Bi","year":"2019","journal-title":"J. Comp. Eff. Res."},{"key":"10.1016\/j.cct.2022.106970_bb0120","doi-asserted-by":"crossref","first-page":"261","DOI":"10.1007\/s00383-019-04610-1","article-title":"Nonoperative treatment for nonperforated appendicitis in children: a systematic review and meta-analysis","volume":"36","author":"Maita","year":"2020","journal-title":"Pediatr. Surg. Int."},{"key":"10.1016\/j.cct.2022.106970_bb0125","first-page":"19","article-title":"Meta-analysis of studies comparing conservative treatment with antibiotics and appendectomy for acute appendicitis in the adult","author":"Yang","year":"2019","journal-title":"BMC Surg."},{"key":"10.1016\/j.cct.2022.106970_bb0130","doi-asserted-by":"crossref","DOI":"10.1371\/journal.pone.0220202","article-title":"Cost analysis of antibiotic therapy versus appendectomy for treatment of uncomplicated acute appendicitis: 5-year results of the APPAC randomized clinical trial","volume":"14","author":"Haijanen","year":"2019","journal-title":"PLoS One"},{"key":"10.1016\/j.cct.2022.106970_bb0135","doi-asserted-by":"crossref","first-page":"1030","DOI":"10.1097\/SLA.0000000000003646","article-title":"Nonoperative treatment versus appendectomy for acute nonperforated appendicitis in children: five-year follow up of a randomized controlled pilot trial","volume":"271","author":"Patkova","year":"2020","journal-title":"Ann. Surg."},{"key":"10.1016\/j.cct.2022.106970_bb0140","doi-asserted-by":"crossref","first-page":"408","DOI":"10.1001\/jamasurg.2015.4534","article-title":"Effectiveness of patient choice in nonoperative vs surgical Management of Pediatric Uncomplicated Acute Appendicitis","volume":"151","author":"Minneci","year":"2016","journal-title":"JAMA Surg"},{"key":"10.1016\/j.cct.2022.106970_bb0145","first-page":"1","article-title":"Appendectomy versus non-operative treatment for acute uncomplicated appendicitis in children: study protocol for a multicentre, open-label, non-inferiority, randomised controlled trial","author":"Hall","year":"2017","journal-title":"BMJ Paediatr. Open"},{"key":"10.1016\/j.cct.2022.106970_bb0150","first-page":"141","article-title":"Antibiotic allergy in pediatrics","author":"Norton","year":"2018","journal-title":"Pediatrics"},{"key":"10.1016\/j.cct.2022.106970_bb0155","doi-asserted-by":"crossref","first-page":"604","DOI":"10.3399\/bjgp14X682561","article-title":"Antibiotic overuse: a key driver of antimicrobial resistance","volume":"64","author":"Shallcross","year":"2014","journal-title":"Br. J. Gen. Pract."},{"key":"10.1016\/j.cct.2022.106970_bb0160","first-page":"8","article-title":"The effects of antibiotics on the microbiome throughout development and alternative approaches for therapeutic modulation","author":"Langdon","year":"2016","journal-title":"Genome Med."},{"key":"10.1016\/j.cct.2022.106970_bb0165","first-page":"5","article-title":"Antibiotic use and the development of inflammatory bowel disease: a national case-control study in Sweden","author":"Nguyen","year":"2020","journal-title":"Lancet Gastroenterol. Hepatol."},{"key":"10.1016\/j.cct.2022.106970_bb0170","article-title":"A randomised placebo-controlled double-blind multicentre trial comparing antibiotic therapy with placebo in the treatment of uncomplicated acute appendicitis: APPAC III trial study protocol","volume":"8","author":"Sippola","year":"2018","journal-title":"BMJ Open"},{"key":"10.1016\/j.cct.2022.106970_bb0175","doi-asserted-by":"crossref","DOI":"10.1016\/j.jpedsurg.2021.01.023","article-title":"Determining the impact of body mass index on ultrasound accuracy for diagnosing appendicitis: is it less useful in obese children?","author":"Tantisook","year":"2021","journal-title":"J. Pediatr. Surg."},{"key":"10.1016\/j.cct.2022.106970_bb0180","first-page":"3","article-title":"The PedsQLTM* 4.0 as a pediatric population health measure: feasibility, reliability, and validity","author":"Varni","year":"2003","journal-title":"Ambul. Pediatr."},{"key":"10.1016\/j.cct.2022.106970_bb0185","doi-asserted-by":"crossref","first-page":"312","DOI":"10.1016\/j.jpedsurg.2019.10.032","article-title":"Application of the Clavien-Dindo classification to a pediatric surgical network","volume":"55","author":"Thompson","year":"2020","journal-title":"J. Pediatr. Surg."},{"key":"10.1016\/j.cct.2022.106970_bb0190","series-title":"The Clavien-Dindo Classification","year":"2022"},{"key":"10.1016\/j.cct.2022.106970_bb0195","first-page":"41","article-title":"Intestinal microbiota signatures associated with histological liver steatosis in pediatric-onset intestinal failure","author":"Korpela","year":"2017","journal-title":"J. Parenter. Enter. Nutr."},{"key":"10.1016\/j.cct.2022.106970_bb0200","first-page":"42","article-title":"Research electronic data capture (REDCap)-a metadata-driven methodology and workflow process for providing translational research informatics support","author":"Harris","year":"2009","journal-title":"J. Biomed. Inform."},{"key":"10.1016\/j.cct.2022.106970_bb0205","first-page":"95","article-title":"The REDCap consortium: building an international community of software platform partners","author":"Harris","year":"2019","journal-title":"J. Biomed. Inform."},{"key":"10.1016\/j.cct.2022.106970_bb0210","doi-asserted-by":"crossref","first-page":"48","DOI":"10.1308\/003588413X13511609954851","article-title":"Role of the faecolith in modern-day appendicitis","volume":"95","author":"Singh","year":"2013","journal-title":"Ann. R. Coll. Surg. Engl."},{"key":"10.1016\/j.cct.2022.106970_bb0215","doi-asserted-by":"crossref","first-page":"889","DOI":"10.1016\/j.jpedsurg.2007.12.034","article-title":"Appendiceal fecalith is associated with early perforation in pediatric patients","volume":"43","author":"Alaedeen","year":"2008","journal-title":"J. Pediatr. Surg."},{"key":"10.1016\/j.cct.2022.106970_bb0220","doi-asserted-by":"crossref","first-page":"2299","DOI":"10.1001\/jama.2021.20502","article-title":"Diagnosis and management of acute appendicitis in adults: a review","volume":"326","author":"Moris","year":"2021","journal-title":"JAMA"},{"key":"10.1016\/j.cct.2022.106970_bb0225","first-page":"110","article-title":"Diagnosis of uncomplicated and complicated appendicitis in adults","author":"Bom","year":"2021","journal-title":"Scand. J. Surg."},{"key":"10.1016\/j.cct.2022.106970_bb0230","first-page":"156","article-title":"Factors associated with primary nonresponsiveness to antibiotics in adults with uncomplicated acute appendicitis","author":"Haijanen","year":"2021","journal-title":"JAMA Surg"},{"key":"10.1016\/j.cct.2022.106970_bb0235","doi-asserted-by":"crossref","first-page":"957","DOI":"10.2214\/AJR.12.9801","article-title":"Ultrasound for differentiation between perforated and nonperforated appendicitis in pediatric patients","volume":"200","author":"Blumfield","year":"2013","journal-title":"AJR Am. J. Roentgenol."},{"key":"10.1016\/j.cct.2022.106970_bb0240","article-title":"Parental views on the non-operative management of simple appendicitis in children: results of a cross-sectional survey","author":"Ensor","year":"2021","journal-title":"World J. Surg."},{"key":"10.1016\/j.cct.2022.106970_bb0245","first-page":"36","article-title":"The immunological functions of the appendix: an example of redundancy?","author":"Girard-Madoux","year":"2018","journal-title":"Semin. Immunol."},{"key":"10.1016\/j.cct.2022.106970_bb0250","doi-asserted-by":"crossref","first-page":"111","DOI":"10.1016\/j.jpedsurg.2015.10.024","article-title":"Nonoperative treatment of acute appendicitis in children: a feasibility study","volume":"51","author":"Hartwich","year":"2016","journal-title":"J. Pediatr. Surg."},{"key":"10.1016\/j.cct.2022.106970_bb0255","first-page":"29","article-title":"Histopathological findings in appendectomy specimens: a study of 24,697 cases","author":"Charfi","year":"2014","journal-title":"Int. J. Color. Dis."},{"key":"10.1016\/j.cct.2022.106970_bb0260","first-page":"82","article-title":"Predicting appendiceal tumors among patients with appendicitis","author":"Loftus","year":"2017","journal-title":"J. Trauma Acute Care Surg."},{"key":"10.1016\/j.cct.2022.106970_bb0265","doi-asserted-by":"crossref","first-page":"157","DOI":"10.1007\/s00384-019-03453-5","article-title":"Risk factors for appendiceal neoplasm and malignancy among patients with acute appendicitis","volume":"35","author":"Brunner","year":"2020","journal-title":"Int. J. Color. Dis."},{"key":"10.1016\/j.cct.2022.106970_bb0270","doi-asserted-by":"crossref","first-page":"372","DOI":"10.1055\/s-2008-1072394","article-title":"Carcinoid tumors of the appendix in children--epidemiology, clinical aspects and procedure","volume":"10","author":"Doede","year":"2000","journal-title":"Eur. J. Pediatr. Surg."},{"key":"10.1016\/j.cct.2022.106970_bb0275","first-page":"154","article-title":"Risk of appendiceal neoplasm in periappendicular abscess in patients treated with interval appendectomy vs follow-up with magnetic resonance imaging: 1-year outcomes of the peri-appendicitis acuta randomized clinical trial","author":"M\u00e4llinen","year":"2019","journal-title":"JAMA Surg"},{"key":"10.1016\/j.cct.2022.106970_bb0280","first-page":"34","article-title":"Appendiceal neoplasm risk associated with complicated acute appendicitis\u2014a population based study","author":"Lietz\u00e9n","year":"2019","journal-title":"Int. J. Color. Dis."}],"container-title":["Contemporary Clinical Trials"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1551714422002968?httpAccept=text\/xml","content-type":"text\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/api.elsevier.com\/content\/article\/PII:S1551714422002968?httpAccept=text\/plain","content-type":"text\/plain","content-version":"vor","intended-application":"text-mining"}],"deposited":{"date-parts":[[2025,10,27]],"date-time":"2025-10-27T08:57:02Z","timestamp":1761555422000},"score":1,"resource":{"primary":{"URL":"https:\/\/linkinghub.elsevier.com\/retrieve\/pii\/S1551714422002968"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,12]]},"references-count":56,"alternative-id":["S1551714422002968"],"URL":"https:\/\/doi.org\/10.1016\/j.cct.2022.106970","relation":{},"ISSN":["1551-7144"],"issn-type":[{"value":"1551-7144","type":"print"}],"subject":[],"published":{"date-parts":[[2022,12]]},"assertion":[{"value":"Elsevier","name":"publisher","label":"This article is maintained by"},{"value":"A randomized, controlled multicenter feasibility pilot trial on imaging confirmed uncomplicated acute appendicitis: Appendectomy vs. symptomatic treatment in pediatric patients (the APPSYPP) trial study protocol","name":"articletitle","label":"Article Title"},{"value":"Contemporary Clinical Trials","name":"journaltitle","label":"Journal Title"},{"value":"https:\/\/doi.org\/10.1016\/j.cct.2022.106970","name":"articlelink","label":"CrossRef DOI link to publisher maintained version"},{"value":"article","name":"content_type","label":"Content Type"},{"value":"\u00a9 2022 Published by Elsevier Inc.","name":"copyright","label":"Copyright"}],"article-number":"106970"}}