Modified Alvarado Scoring System as a diagnostic tool for XXXX at Bugando Medical Centre, Mwanza, Tanzania.

@entity1 @entity697 @entity698
BACKGROUND: Decision-making in @entity1 with @entity697 poses a diagnostic challenge worldwide, despite much advancement in abdominal surgery. The Modified Alvarado Scoring System (MASS) has been reported to be a cheap and quick diagnostic tool in @entity1 with @entity697 . However, differences in diagnostic accuracy have been observed if the scores were applied to various populations and clinical settings. The purpose of this study was to evaluate the diagnostic value of Modified Alvarado Scoring System in @entity1 with @entity697 in our setting. METHODS: A cross-sectional study involving all @entity1 suspected to have @entity697 at Bugando Medical Centre over a six-month period between November 2008 and April 2009 was conducted. All @entity1 who met the inclusion criteria were consecutively enrolled in the study. They were evaluated on admission using the MASS to determine whether they had @entity697 or not. All @entity1 underwent appendicectomy according to the hospital protocol. The decision to operate was the prerogative of the surgeon or surgical resident based on overall clinical judgment and not the MASS. The diagnosis was confirmed by histopathological examination. Data was collected using a pre-tested coded questionnaire and analyzed using SPSS statistical computer software. RESULTS: A total number of 127 @entity1 were studied. Their ages ranged from eight to 76 years (mean 29.64    12.97). There were 37 (29.1%) males and 90 (70.9%) females (M: F = 1:2.4). All @entity1 in this study underwent appendicectomy. The perforation rate was 9.4%. Histopathological examination confirmed @entity698 in 85 @entity1 (66.9%) and the remaining 42 @entity1 had normal appendix giving a negative appendicectomy rate of 33.1% (26.8% for males and 38.3% for females). The sensitivity and specificity of MASS in this study were 94.1% (males 95.8% and females 88.3%) and 90.4% (males 92.9% and females 89.7%) respectively. The Positive Predictive Value and Negative Predictive Value were 95.2% (males 95.5% and females 90.6%) and 88.4% (males 89.3% and females 80.1%) respectively. The accuracy of MASS was 92.9% (males 91.5% and females 87.6%). CONCLUSION: The study shows that use of MASS in @entity1 suspected to have @entity697 provides a high degree of diagnostic accuracy and can be employed at Bugando Medical Centre to improve the diagnostic accuracy of @entity697 and subsequently reduces negative appendicectomy and complication rates. However, additional investigations may be required to confirm the diagnosis in case of atypical presentation.
