Structured data collection improves the diagnosis of acute appendicitis

Br J Surg. 1998 Mar;85(3):341-4. doi: 10.1046/j.1365-2168.1998.00627.x.


Background: Structured preoperative data collection and computer-assisted methods are claimed to improve diagnostic accuracy in patients with acute abdominal pain. The aim of this study was to evaluate a possible age- and sex-related effect of using structured data collection in the preoperative diagnosis of patients with suspected acute appendicitis.

Methods: Between 1989 and 1994, clinical and demographic data from 1764 consecutive patients were recorded. In 1990 and 1992, various detailed symptom, clinical and laboratory data were collected prospectively on a structured registration form. Age- and sex-specific diagnostic accuracy as well as perforation rate were calculated for each year.

Results: Diagnostic accuracy increased significantly by 5 (95 per cent confidence interval (c.i.) 1-9) per cent when structured data registration was applied. In female patients aged between 13 and 40 years, diagnostic accuracy increased by 16 (95 per cent c.i. 8-24) per cent. Significant changes in diagnostic accuracy were not seen in other subgroups. Perforation rates remained unchanged during the entire study period.

Conclusion: In this population-based study, diagnostic accuracy in patients operated on for suspected acute appendicitis increased for all patients when structured preoperative data collection was used. However, the only subgroup with a significant increase in diagnostic accuracy was female patients aged between 13 and 40 years. Perforation rate was unaffected by structured data collection.

MeSH terms

  • Acute Disease
  • Adolescent
  • Adult
  • Age Distribution
  • Aged
  • Appendicitis / diagnosis*
  • Child
  • Child, Preschool
  • Data Collection / methods*
  • Female
  • Humans
  • Infant
  • Infant, Newborn
  • Intestinal Perforation / diagnosis
  • Male
  • Medical Records
  • Middle Aged
  • Prospective Studies
  • Sensitivity and Specificity
  • Sex Distribution
  • Time Factors