{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,24]],"date-time":"2026-06-24T10:07:28Z","timestamp":1782295648363,"version":"3.54.5"},"reference-count":21,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"8","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:sec>\n            <jats:title>Objectives:<\/jats:title>\n            <jats:p>To validate clinical scores [Testicular Workup for Ischemia and Suspected Torsion (TWIST), testicular torsion (TT) score, Artificial Intelligence\u2013based Score (AIS), Boettcher Alert Score (BALS)] when evaluating children under 18 with non-traumatic testicular pain in the emergency department. Our secondary objective was to create and compare a new TT score [Testicular Emergency Score for Torsion (TEST) score].<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Methods:<\/jats:title>\n            <jats:p>This was a multicenter prospective study in 21 Spanish pediatric emergency departments between 2020 and 2022, including 903 children 3 months to 18 years old with non-traumatic unilateral testicular pain, of them 93 TT (10.3%). To create a new score, the sample was randomly divided into derivation and validation set.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Results:<\/jats:title>\n            <jats:p>The performance of the TWIST, TT score, AIS, and BALS was good, and the proportion of patients correctly classified as low risk was 37.9%, 52.7%, 30.3%, and 28%, respectively. The TEST score included the following predictors of TT identified by multivariable logistic regression analysis: age, duration of pain, nausea\/vomiting, testicular volume increase, testicular elevation, induration, and absence of cremasteric reflex. TEST score had a higher area under the receiver operating curve (area under the curve) and correctly classified in the low-risk group of 63.6% of the patients.<\/jats:p>\n          <\/jats:sec>\n          <jats:sec>\n            <jats:title>Conclusions:<\/jats:title>\n            <jats:p>Although TWIST, TT score, BALS, and AIS scores showed a good performance, the TEST score identifies a larger group of low-risk patients suitable for safe management without Doppler ultrasound.<\/jats:p>\n          <\/jats:sec>","DOI":"10.1097\/pec.0000000000003394","type":"journal-article","created":{"date-parts":[[2025,4,15]],"date-time":"2025-04-15T07:00:07Z","timestamp":1744700407000},"page":"620-627","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":2,"title":["Clinical Prediction Rules for Identifying Children With Testicular Torsion"],"prefix":"10.1097","volume":"41","author":[{"given":"Marcela P\u00eda","family":"Valdivieso-Castro","sequence":"first","affiliation":[{"name":"Department of Pediatric Surgery, Cruces University Hospital, Barakaldo, Basque Country"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lorena","family":"V\u00e1zquez-G\u00f3mez","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Ferrol University Hospital"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mikel","family":"Olabarri","sequence":"additional","affiliation":[{"name":"Department of Pediatric Emergency, Cruces University Hospital, University of the Basque Country, Barakaldo, Basque Country"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Iv\u00e1n","family":"Presno-L\u00f3pez","sequence":"additional","affiliation":[{"name":"Teresa Herrera Hospital, A Coru\u00f1a, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roc\u00edo","family":"Espinosa-G\u00f3ngora","sequence":"additional","affiliation":[{"name":"Department of Pediatric Surgery, Ni\u00f1o Jes\u00fas University Children\u2019s Hospital, Madrid"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Orejuela-Ribera","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, Hospital Universitari Joan XXIII de Tarragona"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amaia","family":"C\u00e1mara-Otegui","sequence":"additional","affiliation":[{"name":"Department of Pediatric Emergency, Donostia University Hospital, San Sebasti\u00e1n, Spain"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sandra","family":"Rodr\u00edguez-Fern\u00e1ndez","sequence":"additional","affiliation":[{"name":"Cabue\u00f1es University Hospital. 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