{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,30]],"date-time":"2026-07-30T17:45:22Z","timestamp":1785433522292,"version":"3.56.0"},"reference-count":13,"publisher":"Michigan State University College of Osteopathic Medicine Statewide Campus System","issue":"2","license":[{"start":{"date-parts":[[2020,1,30]],"date-time":"2020-01-30T00:00:00Z","timestamp":1580342400000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"abstract":"<jats:sec id=\"context\">\n                    <jats:title>CONTEXT<\/jats:title>\n                    <jats:p>Since the 1980s, the use of ultrasonography for suspected acute pediatric appendicitis has become increasingly common. Multiple studies have suggested that ultrasound of the appendix has consistently high sensitivity and specificity when the appendix can be clearly visualized. The authors\u2019 primary objective for this study was to retrospectively evaluate their community-based healthcare system\u2019s processes for detecting acute pediatric appendicitis using ultrasonography.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"methods\">\n                    <jats:title>METHODS<\/jats:title>\n                    <jats:p>This was a retrospective medical chart review study of data over a five-year 2014-2018 period at Mercy Health Muskegon in Muskegon, Michigan. All patients aged 3-18 years who had received an appendix ultrasound during this period were identified using the McKesson Radiology (MS) PACS-Lite computer program. Pediatric appendix ultrasound cases were collected and analyzed for sensitivity, specificity, positive predictive value, negative predictive value with 95% confidence intervals. Acute appendicitis cases had been confirmed based on pathology reports. Secondary measures including white blood cell, body mass index, and body temperature were also included in analyses.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"results\">\n                    <jats:title>RESULTS<\/jats:title>\n                    <jats:p>In this sample, the overall sensitivity at detecting acute pediatric appendicitis using ultrasonography was relatively low at approximately 42% (95% CI: 21.1 - 66.0%). On the other hand, sample specificity was quite high at 97% (95% CI: 89.9 \u2013 99.5%). The overall positive predictive value (PPV) was 80% (95% CI: 44.2-96.5%) and the negative predictive Value (NPV) was 86% (95% CI: 75.7-92.4%). The occurrence for false positives was 20% (95% CI: 3.5-55.8%). False negatives were 14% (95% CI: 7.6-24.3%).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"conclusions\">\n                    <jats:title>CONCLUSIONS<\/jats:title>\n                    <jats:p>The use of ultrasonography at the authors\u2019 institution less often accurately identified cases of later-confirmed pediatric appendicitis compared to some earlier published studies. The authors concluded that this could be due to seeing a lower number of more complex\/ambiguous cases of pediatric appendicitis or lack of hospital personnel\u2019s pediatric-specific training and\/or experience compared to specialty children\u2019s hospitals. It is possible that imaging improvements could be achieved by either or a combination of: offering training sessions for general ultrasound technicians, offering training session for radiologists, and visiting pediatric physicians and ultrasound technicians. A valuable follow-up study would be to track anticipated improvements and lead to formulation of an acute pediatric appendicitis care protocol within the authors\u2019 healthcare system.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.51894\/001c.11639","type":"journal-article","created":{"date-parts":[[2021,2,15]],"date-time":"2021-02-15T14:20:46Z","timestamp":1613398846000},"source":"Crossref","is-referenced-by-count":4,"title":["An Evaluation of a Community Hospital\u2019s Emergency Department Ultrasonography Processes for the Diagnosis of Acute Pediatric Appendicitis"],"prefix":"10.51894","volume":"4","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4063-799X","authenticated-orcid":false,"given":"Tanner","family":"Davis","sequence":"first","affiliation":[{"name":"Mercy Health Muskegon","department":["Emergency Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Samuel J.","family":"Wisniewski","sequence":"additional","affiliation":[{"id":[{"id":"https:\/\/ror.org\/05hs6h993","id-type":"ROR","asserted-by":"publisher"}],"name":"Michigan State University","department":["College of Osteopathic Medicine Statewide Campus System"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Heidi","family":"Suidinski","sequence":"additional","affiliation":[{"name":"Mercy Health Muskengon","department":["Emergency Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joe","family":"Betcher","sequence":"additional","affiliation":[{"name":"Mercy Health Muskegon","department":["Emergency Medicine"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"29343","published-online":{"date-parts":[[2020,1,30]]},"reference":[{"issue":"6","key":"ref1","doi-asserted-by":"publisher","first-page":"912","DOI":"10.1016\/j.jpedsurg.2016.02.055","article-title":"Diagnostic imaging practices for children with suspected appendicitis evaluated at definitive care hospitals and their associated referral centers","volume":"51","author":"Charity C. Glass","year":"2016","journal-title":"Journal of Pediatric Surgery","ISSN":"https:\/\/id.crossref.org\/issn\/0022-3468","issn-type":"print"},{"issue":"9","key":"ref2","doi-asserted-by":"publisher","first-page":"1035","DOI":"10.1111\/acem.13445","article-title":"Bedside sonography performed by emergency physicians to detect appendicitis in children","volume":"25","author":"Marie Nicole","year":"2018","journal-title":"Academic Emergency Medicine","ISSN":"https:\/\/id.crossref.org\/issn\/1069-6563","issn-type":"print"},{"issue":"6","key":"ref3","doi-asserted-by":"publisher","first-page":"877","DOI":"10.1053\/jpsu.2002.32893","article-title":"Pediatric appendicitis score","volume":"37","author":"Madan Samuel","year":"2002","journal-title":"Journal of Pediatric Surgery","ISSN":"https:\/\/id.crossref.org\/issn\/0022-3468","issn-type":"print"},{"key":"ref4","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/j.jpeds.2016.11.062","article-title":"Clinical relevance of the non-visualized appendix on ultrasonography of the abdomen in children","volume":"182","author":"S.A. 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Guideline on diagnosis and treatment of acute appendicitis: Imaging prior to appendectomy is recommended","volume":"154:A303","author":"O.J. Bakker","year":"2010","journal-title":"Nederlands Tijdschrift voor Geneeskunde"},{"issue":"3","key":"ref8","doi-asserted-by":"publisher","first-page":"693","DOI":"10.1007\/s00268-016-3792-7","article-title":"Diagnostic Accuracy of Abdominal Ultrasound for Diagnosis of Acute Appendicitis: Systematic Review and Meta-analysis","volume":"41","author":"Vanja Giljaca","year":"2017","journal-title":"World Journal of Surgery","ISSN":"https:\/\/id.crossref.org\/issn\/0364-2313","issn-type":"print"},{"issue":"7","key":"ref9","doi-asserted-by":"publisher","first-page":"697","DOI":"10.1111\/acem.12161","article-title":"Performance of ultrasound in the diagnosis of appendicitis in children in a multicenter cohort","volume":"20","author":"Manoj K. 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A Meta-analysis","volume":"47","author":"Hanfei Zhang","year":"2017","journal-title":"Pediatric Radiology","ISSN":"https:\/\/id.crossref.org\/issn\/0301-0449","issn-type":"print"},{"issue":"5","key":"ref13","doi-asserted-by":"publisher","first-page":"917","DOI":"10.1016\/j.amjsurg.2018.03.017","article-title":"Does the implementation of a pediatric appendicitis pathway promoting ultrasound work outside of a children's hospital?","volume":"215","author":"Emily Kobayashi","year":"2018","journal-title":"The American Journal of Surgery","ISSN":"https:\/\/id.crossref.org\/issn\/0002-9610","issn-type":"print"}],"container-title":["Spartan Medical Research Journal"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/smrj.scholasticahq.com\/article\/11639-an-evaluation-of-a-community-hospital-s-emergency-department-ultrasonography-processes-for-the-diagnosis-of-acute-pediatric-appendicitis","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,6,16]],"date-time":"2025-06-16T12:44:28Z","timestamp":1750077868000},"score":1,"resource":{"primary":{"URL":"https:\/\/smrj.scholasticahq.com\/article\/11639-an-evaluation-of-a-community-hospital-s-emergency-department-ultrasonography-processes-for-the-diagnosis-of-acute-pediatric-appendicitis"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2020,1,30]]},"references-count":13,"journal-issue":{"issue":"2","published-online":{"date-parts":[[2020]]}},"URL":"https:\/\/doi.org\/10.51894\/001c.11639","relation":{},"ISSN":["2474-7629"],"issn-type":[{"value":"2474-7629","type":"electronic"}],"subject":[],"published":{"date-parts":[[2020,1,30]]}}}