Decreased use of computed tomography with a modified clinical scoring system in diagnosis of pediatric XXXX .

@entity1 @entity697 @entity698 @entity5 @entity3224
HYPOTHESIS: Use of a modified clinical grading score improves accuracy in diagnosing @entity697 in the pediatric population while decreasing the use of computed tomography (CT). DESIGN: Retrospective medical records review after approval by the institutional review board. We determined the Alvarado score for each @entity1 and correlated it with the pathological findings and imaging studies to evaluate the efficacy of CT and its attendant radiation exposure. SETTING: Community teaching hospital. @entity1 : Sixty-one @entity1 , aged 3 to 16 years, admitted with suspected @entity697 . MAIN OUTCOME MEASURES: Sensitivity, specificity, and accuracy of the modified Alvarado scoring system. RESULTS: The standard Alvarado score for @entity697 had a sensitivity of 92% and a specificity of 82%, with an accuracy of 92%. In the modified Alvarado scoring system, CT findings were substituted for Alvarado scores in the ranges of 5 or 6, 5 to 7, 5 to 8, and 5 to 9. The modification resulted in the greatest accuracy (98%) in diagnosing @entity698 in @entity1 with scores in the range of 5 to 7. This modification theoretically would have decreased the use of CT by about 27% in this group of retrospectively studied @entity1 . Furthermore, in @entity1 with Alvarado scores of 1 to 4, another diagnosis should be considered; in @entity1 with scores of 5 to 7, CT should be performed; and, in @entity1 with scores of 8 to 10, an appendectomy should be performed promptly without further studies. CONCLUSIONS: The modified Alvarado score is useful as an @entity3224 in diagnosing @entity697 in the pediatric population. This scoring system eliminates unnecessary use of CT and the attendant potential @entity5 -inducing radiation in the pediatric population.
