• G Fenyö.
• Department of Surgery, Nacka Hospital, Sweden.
• Acta Chir Scand. 1987 Sep 1;153(9):545-51.

AbstractClinical data from 259 patients with suspected acute appendicitis were prospectively collected and used in construction of a Bayesian scoring system, comprising 19 attributes, for preoperative diagnosis. The scoring system was integrated into the routine clinical management of a prospective series of 830 patients. Laparotomy was performed in 310 cases, and of these 256 had acute appendicitis (perforation in 14%). Excluding 6 cases with normal appendix but laparotomy mandatory for other reasons, the negative laparotomy rate was 15.5%. This rate was significantly lower than in earlier series from the same hospital and in more than 8,000 appendectomies performed in Sweden since 1969. The scoring system had 90.2% sensitivity, 91.4% specificity, 82.5% positive predictive value and 95.4% negative predictive value. The system is regarded only as an aid in diagnosis, to be used in combination with clinicians' judgements. Construction of a local data base probably is essential for results equivalent to those here reported.

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