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Good Positive and Negative Likelihood Ratios

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Appendicitis: Likelihood Ratios

Introduction: None written.

[Edit Diagnosis] [Merge dx] [Add prevalence]

Tags: Gastrointestinal Problem Infection Tag this Diagnosis.

Prevalence

Population / CalculatorPrevalence Comments / Study / Link
Adults >60 years old, abdominal pain in the ED 4% http://jama.ama-assn.org/cgi/content/abstract/276/19/1589
Adults, abdominal pain in ambulatory setting 1% http://jama.ama-assn.org/cgi/content/abstract/276/19/1589
Adults <60 years old, abdominal pain in ED 25% http://jama.ama-assn.org/cgi/content/abstract/276/19/1589
More, Edit...

The likelihood ratios of findings for Appendicitis are listed below. See the left navigation bar to change the display.

Good Positive and Negative Likelihood Ratios

Finding +LR-LR Comments, Study
Pain preceeding vomiting Edit 2.80

Based on only one study

Study: JAMA. 1996;276(19):1589-1594

http://jama.ama-assn.org/cgi/content/abstract/276/19/1589

Abdominal CT Edit 18.80.1

Usually radiologists like the CTs to be done with rectal contrast. However, there may not be a sensitivity difference between with and without contrast; see PMID: 17456874, PMID: 16105539, though other studies disagree PMID: 17566826.

Study: Ann Intern Med 2004 Oct 5;141(7):537-46. PMID 15466771

Abdominal US Edit 4.50.2

Study: Ann Intern Med 2004 Oct 5;141(7):537-46. PMID 15466771

Appendicolith Edit 4.60.4

By CT. In children

Study: AJR Am J Roentgenol. 2000 Oct;175(4):981-4. PMID: 11000148

Fever
Duplicate Edit
3.20.4

Study: JAMA. 1996;276(19):1589-1594

http://jama.ama-assn.org/cgi/content/abstract/276/19/1589

Migration of Pain Edit 3.60.4

Study: JAMA. 1996;276(19):1589-1594

http://jama.ama-assn.org/cgi/content/abstract/276/19/1589

Good Negative Likelihood Ratio

Finding +LR-LR Comments, Study
RLQ Pain Edit 1.70.4

Study: JAMA. 1996;276(19):1589-1594

http://jama.ama-assn.org/cgi/content/abstract/276/19/1589

Guarding Edit 1.70.5

Study: JAMA. 1996;276(19):1589-1594

http://jama.ama-assn.org/cgi/content/abstract/276/19/1589

No similar pain previously Edit 1.40.5

Study: JAMA. 1996;276(19):1589-1594

http://jama.ama-assn.org/cgi/content/abstract/276/19/1589

Leukocytosis Edit 1.60.5

>10k

Study: Acad Emerg Med. 2004 Oct;11(10):1021-7. PMID: 15466143

Good Positive Likelihood Ratio

Finding +LR-LR Comments, Study
Psoas sign Edit 3.20.9

With the patient in the supine position, ask the patient to lift the right thigh against your hand placed just above the knee. With the patient in left lateral decubitus position, extend the right leg at the hip.

Study: JAMA. 1996;276(19):1589-1594

http://jama.ama-assn.org/cgi/content/abstract/276/19/1589

Rebound Edit 20.5

Study: JAMA. 1996;276(19):1589-1594

http://jama.ama-assn.org/cgi/content/abstract/276/19/1589

Poorly Diagnostic Findings

Finding +LR-LR Comments, Study
Abdominal Rigidity Edit 1.60.9

Study: JAMA. 1996;276(19):1589-1594

http://jama.ama-assn.org/cgi/content/abstract/276/19/1589

Rectal tenderness Edit 1.80.8

Study: JAMA. 1996;276(19):1589-1594

http://jama.ama-assn.org/cgi/content/abstract/276/19/1589

Fever
Duplicate Edit
1.30.8

>99F

Study: Acad Emerg Med. 2004 Oct;11(10):1021-7. PMID: 15466143

Emesis Edit 0.91.1

Study: JAMA. 1996;276(19):1589-1594

http://jama.ama-assn.org/cgi/content/abstract/276/19/1589

Nausea Edit 0.91.1

Study: JAMA. 1996;276(19):1589-1594

http://jama.ama-assn.org/cgi/content/abstract/276/19/1589

Anorexia Edit 1.10.9

Study: JAMA. 1996;276(19):1589-1594

http://jama.ama-assn.org/cgi/content/abstract/276/19/1589

Findings With Unspecified Accuracy

Finding +LR-LR Comments, Study
Obturator sign Edit No accuracy specified.

Passively flex the right leg at the hip and knee and internally rotate the leg at the hip.

Study: No studies but thought to be equivalent to psoas sign in accuracy.

Rovsing's Sign Edit No accuracy specified.

palpation of the lower left quadrant of a person's abdomen results in more pain in the right lower quadrant

Study: no study specified.