{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,14]],"date-time":"2026-01-14T23:47:19Z","timestamp":1768434439119,"version":"3.49.0"},"reference-count":14,"publisher":"BMJ","issue":"1","content-domain":{"domain":["bmj.com"],"crossmark-restriction":true},"short-container-title":["BMJ Open"],"accepted":{"date-parts":[[2017,7,20]]},"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec>\n                  <jats:title>Introduction<\/jats:title>\n                  <jats:p>Patients presenting with right iliac fossa (RIF) pain are a common challenge for acute general surgical services. Given the range of potential pathologies, RIF pain creates diagnostic uncertainty and there is subsequent variation in investigation and management. Appendicitis is a diagnosis which must be considered in all patients with RIF pain; however, over a fifth of patients undergoing appendicectomy, in the UK, have been proven to have a histologically normal appendix (negative appendicectomy). The primary aim of this study is to determine the contemporary negative appendicectomy rate. The study\u2019s secondary aims are to determine the rate of laparoscopy for appendicitis and to validate the Appendicitis Inflammatory Response (AIR) and Alvarado prediction scores.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and analysis<\/jats:title>\n                  <jats:p>This multicentre, international prospective observational study will include all patients referred to surgical specialists with either RIF pain or suspected appendicitis. Consecutive patients presenting within 2-week long data collection periods will be included. Centres will be invited to participate in up to four data collection periods between February and August 2017. Data will be captured using a secure online data management system. A centre survey will profile local policy and service delivery for management of RIF pain.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Ethics and dissemination<\/jats:title>\n                  <jats:p>Research ethics are not required for this study in the UK, as determined using the National Research Ethics Service decision tool. This study will be registered as a clinical audit in participating UK centres. National leads in countries outside the UK will oversee appropriate registration and study approval, which may include completing full ethical review. The study will be disseminated by trainee-led research collaboratives and through social media. Peer-reviewed publications will be published under corporate authorship including \u2018RIFT Study Group\u2019 and \u2018West Midlands Research Collaborative\u2019.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2017-017574","type":"journal-article","created":{"date-parts":[[2018,1,13]],"date-time":"2018-01-13T06:40:19Z","timestamp":1515825619000},"page":"e017574","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":13,"title":["Right Iliac Fossa Pain Treatment (RIFT) Study: protocol for an international, multicentre, prospective observational study"],"prefix":"10.1136","volume":"8","author":[{"name":"RIFT Study Group On behalf of the West Midlands Research Collaborative","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"239","published-online":{"date-parts":[[2018,1,13]]},"reference":[{"key":"2025101814444651000_8.1.e017574.1","unstructured":"Royal College of Surgeons and Association of Surgeons of Great Britain and Ireland. 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London, 2014. https:\/\/www.rcseng.ac.uk\/-\/media\/.\/commissioning-guide-egs-published-v3.pdf (accessed on 1 Jan 2017)."},{"key":"2025101814444651000_8.1.e017574.2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(15)00275-5"},{"key":"2025101814444651000_8.1.e017574.3","doi-asserted-by":"publisher","DOI":"10.1007\/s00268-008-9649-y"},{"key":"2025101814444651000_8.1.e017574.4","doi-asserted-by":"publisher","DOI":"10.1016\/S0196-0644(86)80993-3"},{"key":"2025101814444651000_8.1.e017574.5","doi-asserted-by":"crossref","first-page":"1769","DOI":"10.1007\/s00268-017-3926-6","article-title":"Clinical Prediction Rules for Appendicitis in Adults: Which Is Best?","volume":"41","author":"Kularatna","year":"2017","journal-title":"World J Surg"},{"key":"2025101814444651000_8.1.e017574.6","doi-asserted-by":"crossref","first-page":"894","DOI":"10.1097\/SLA.0000000000000492","article-title":"Safety of short, in-hospital delays before surgery for acute appendicitis: multicentre cohort study, systematic review, and meta-analysis","volume":"259","author":"Bhangu","year":"2014","journal-title":"Ann Surg"},{"key":"2025101814444651000_8.1.e017574.7","doi-asserted-by":"publisher","DOI":"10.1002\/bjs.9201"},{"key":"2025101814444651000_8.1.e017574.8","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j1703"},{"key":"2025101814444651000_8.1.e017574.9","doi-asserted-by":"crossref","first-page":"34","DOI":"10.1186\/s13017-016-0090-5","article-title":"WSES Jerusalem guidelines for diagnosis and treatment of acute appendicitis","volume":"11","author":"Di Saverio","year":"2016","journal-title":"World J Emerg Surg"},{"key":"2025101814444651000_8.1.e017574.10","doi-asserted-by":"crossref","first-page":"4668","DOI":"10.1007\/s00464-016-5245-7","article-title":"Diagnosis and management of acute appendicitis. 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