{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,8,18]],"date-time":"2026-08-18T15:09:17Z","timestamp":1787065757596,"version":"build-2736575974"},"reference-count":56,"publisher":"Wiley","issue":"11","license":[{"start":{"date-parts":[[2024,7,17]],"date-time":"2024-07-17T00:00:00Z","timestamp":1721174400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100012155","name":"Channel 7 Telethon Trust","doi-asserted-by":"publisher","award":["2022 CAHS Telethon Research Scholarship"],"award-info":[{"award-number":["2022 CAHS Telethon Research Scholarship"]}],"id":[{"id":"10.13039\/100012155","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Academic Emergency Medicine"],"published-print":{"date-parts":[[2024,11]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>The objective was to investigate the feasibility of prospectively validating multiple clinical prediction scores (CPSs) for pediatric appendicitis in an Australian pediatric emergency department (ED).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A literature search was conducted to identify potential CPSs and a single\u2010center prospective observational feasibility study was performed between November 2022 and May 2023 to evaluate the performance of identified CPSs. Children 5\u201315\u2009years presenting with acute right\u2010sided or generalized abdominal pain and clinician suspicion of appendicitis were included. CPSs were calculated by the study team from prospectively clinician\u2010collected data and\/or review of medical records. Accuracy of CPSs were assessed by area under the receiver operating characteristic curve (AUC) and proportions correctly identifiable as either low\u2010risk or high\u2010risk with the best performing CPS compared to clinician gestalt. Final diagnosis of appendicitis was confirmed on histopathology or by telephone\/email follow\u2010up for those discharged directly from ED.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Thirty CPSs were identified in the literature search and 481 patients were enrolled in the study. A total of 150 (31.2%) patients underwent appendectomy with three (2.0%) having a normal appendix on histopathology. All identified CPSs were calculable for at least 50% of the patient cohort. The pediatric Appendicitis Risk Calculator for pediatric EDs (pARC\u2010ED;\n                      <jats:italic>n<\/jats:italic>\n                      \u2009=\u2009317) was the best performing CPS with AUC 0.90 (95% confidence interval [CI] 0.86\u20130.94) and specificity 99.0% (95% CI 96.4%\u201399.7%) in diagnosing high\u2010risk cases and a misclassification rate of 4.5% for low\u2010risk cases.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>The study identified 30 CPSs that could be validated in a majority of patients to compare their ability to assess risk of pediatric appendicitis. The pARC\u2010ED had the highest predictive accuracy and can potentially assist in risk stratification of children with suspected appendicitis in pediatric EDs. A multicenter study is now under way to evaluate the potential of these CPSs in a broader range of EDs to aid clinical decision making in more varied settings.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/acem.14985","type":"journal-article","created":{"date-parts":[[2024,7,18]],"date-time":"2024-07-18T02:24:15Z","timestamp":1721269455000},"page":"1089-1099","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Study of pediatric appendicitis scores and management strategies: A prospective observational feasibility study"],"prefix":"10.1111","volume":"31","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-1212-1286","authenticated-orcid":false,"given":"Wei Hao","family":"Lee","sequence":"first","affiliation":[{"name":"Emergency Department Perth Children's Hospital  Perth Western Australia Australia"},{"name":"School of Medicine, Division of Paediatrics The University of Western Australia  Perth Western 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