{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,7]],"date-time":"2026-10-07T01:55:45Z","timestamp":1791338145361,"version":"4.3.1"},"reference-count":8,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2007,8,6]],"date-time":"2007-08-06T00:00:00Z","timestamp":1186358400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/www.springer.com\/tdm"}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Emerg Med"],"published-print":{"date-parts":[[2007,12]]},"abstract":"Abstract<\/jats:title>Background<\/jats:title>The acute abdomen is a frequent entity at the Emergency Department (ED), which usually needs rapid and accurate diagnostic work-up. Diagnostic work-up with imaging can consist of plain X-ray, ultrasonography (US), computed tomography (CT) and even diagnostic laparoscopy. However, no evidence-based guidelines exist in current literature. The actual diagnostic work-up of a patient with acute abdominal pain presenting to the ED varies greatly between hospitals and physicians. The OPTIMA study was designed to provide the evidence base for constructing an optimal diagnostic imaging guideline for patients with acute abdominal pain at the ED.<\/jats:p><\/jats:sec>Methods\/design<\/jats:title>Thousand consecutive patients with abdominal pain > 2 hours and < 5 days will be enrolled in this multicentre trial. After clinical history, physical and laboratory examination all patients will undergo a diagnostic imaging protocol, consisting of plain X-ray (upright chest and supine abdomen), US and CT. The reference standard will be a post hoc assignment of the final diagnosis by an expert panel. The focus of the analysis will be on the added value of the imaging modalities over history and clinical examination, relative to the incremental costs.<\/jats:p><\/jats:sec>Discussion<\/jats:title>This study aims to provide the evidence base for the development of a diagnostic algorithm that can act as a guideline for ED physicians to evaluate patients with acute abdominal pain.<\/jats:p><\/jats:sec>","DOI":"10.1186\/1471-227x-7-9","type":"journal-article","created":{"date-parts":[[2007,8,7]],"date-time":"2007-08-07T06:13:33Z","timestamp":1186467213000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":41,"title":["Optimization of diagnostic imaging use in patients with acute abdominal pain (OPTIMA): Design and rationale"],"prefix":"10.1186","volume":"7","author":[{"given":"Wytze","family":"Lam\u00e9ris","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Adrienne","family":"van Randen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marcel GW","family":"Dijkgraaf","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Patrick MM","family":"Bossuyt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jaap","family":"Stoker","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marja A","family":"Boermeester","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2007,8,6]]},"reference":[{"key":"40_CR1","doi-asserted-by":"publisher","first-page":"301","DOI":"10.1016\/0735-6757(95)90204-X","volume":"13","author":"RD Powers","year":"1995","unstructured":"Powers RD, Guertler AT: Abdominal pain in the ED: stability and change over 20 years. Am J Emerg Med. 1995, 13: 301-303. 10.1016\/0735-6757(95)90204-X.","journal-title":"Am J Emerg Med"},{"key":"40_CR2","volume-title":"Spoedeisende hulp bij buikklachten","author":"N van Geloven","year":"2000","unstructured":"van Geloven N: Spoedeisende hulp bij buikklachten. 2000"},{"key":"40_CR3","doi-asserted-by":"publisher","first-page":"145","DOI":"10.1067\/msy.2000.107422","volume":"128","author":"MJ Weyant","year":"2000","unstructured":"Weyant MJ, Eachempati SR, Maluccio MA, Rivadeneira DE, Grobmyer SR, Hydo LJ, et al: Interpretation of computed tomography does not correlate with laboratory or pathologic findings in surgically confirmed acute appendicitis. Surgery. 2000, 128: 145-152. 10.1067\/msy.2000.107422.","journal-title":"Surgery"},{"key":"40_CR4","doi-asserted-by":"crossref","first-page":"1017","DOI":"10.1177\/000313480106701101","volume":"67","author":"GP McDonald","year":"2001","unstructured":"McDonald GP, Pendarvis DP, Wilmoth R: Influence of Preoperative Computed Tomography in Patients Undergoing Appendectomy. American Surgeon. 2001, 67: 1017-1021.","journal-title":"American Surgeon"},{"key":"40_CR5","doi-asserted-by":"publisher","first-page":"556","DOI":"10.1001\/archsurg.136.5.556","volume":"136","author":"ST Lee","year":"2001","unstructured":"Lee ST, Walsh AJ, Ho SH: Computed Tomography and Ultrasonography Do Not Improve and May Delay the Diagnosis and Treatment of Acute Appendicitis. Archives of surgery. 2001, 136: 556-562. 10.1001\/archsurg.136.5.556.","journal-title":"Archives of surgery"},{"key":"40_CR6","doi-asserted-by":"publisher","first-page":"833","DOI":"10.1080\/110241598750005246","volume":"164","author":"AC Moberg","year":"1998","unstructured":"Moberg AC, Ahlberg H, Leijonmarck CE: Diagnostic Laparoscopies in 1043 Patients with Suspected Acute Appendicitis. European Journal of Surgery. 1998, 164: 833-841. 10.1080\/110241598750005246.","journal-title":"European Journal of Surgery"},{"key":"40_CR7","doi-asserted-by":"publisher","first-page":"1387","DOI":"10.1136\/bmj.325.7377.1387","volume":"325","author":"CS Ng","year":"2002","unstructured":"Ng CS, Watson CJE, Palmer CR: Evaluation of early abdominopelvic computed tomography in patients with acute abdominal pain of unknown cause: prospective randomised study. British Medical Journal. 2002, 325: 1387-1390. 10.1136\/bmj.325.7377.1387.","journal-title":"British Medical Journal"},{"key":"40_CR8","unstructured":"U.S. Food and Drug Administration 2007. [http:\/\/www.fda.gov\/cdrh\/ct\/risks.html]"}],"container-title":["BMC Emergency Medicine"],"original-title":[],"language":"en","link":[{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-227X-7-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/article\/10.1186\/1471-227X-7-9\/fulltext.html","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"http:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-227X-7-9","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"},{"URL":"https:\/\/link.springer.com\/content\/pdf\/10.1186\/1471-227X-7-9.pdf","content-type":"application\/pdf","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,5,13]],"date-time":"2023-05-13T18:14:35Z","timestamp":1684001675000},"score":1,"resource":{"primary":{"URL":"https:\/\/bmcemergmed.biomedcentral.com\/articles\/10.1186\/1471-227X-7-9"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2007,8,6]]},"references-count":8,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2007,12]]}},"alternative-id":["40"],"URL":"https:\/\/doi.org\/10.1186\/1471-227x-7-9","relation":{},"ISSN":["1471-227X"],"issn-type":[{"value":"1471-227X","type":"electronic"}],"subject":[],"published":{"date-parts":[[2007,8,6]]},"assertion":[{"value":"27 June 2007","order":1,"name":"received","label":"Received","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 August 2007","order":2,"name":"accepted","label":"Accepted","group":{"name":"ArticleHistory","label":"Article History"}},{"value":"6 August 2007","order":3,"name":"first_online","label":"First Online","group":{"name":"ArticleHistory","label":"Article History"}}],"article-number":"9"}}