Prospective validation of two systems of classification for the diagnosis of XXXX .

@entity1 @entity697 @entity698
OBJECTIVES: The objectives of this study were (1) to validate the Alvarado score and pediatric @entity698 score (PAS) in a prospectively identified pediatric cohort and (2) to assess abdominal ultrasonography (AUS) as a tool to increase the diagnostic reliability of both scores. @entity1 AND METHODS: Prospective study conducted from January 10, 2008, to January 1, 2009. All @entity1 attended at the emergency department with suspected @entity697 ( @entity697 ) who had a blood sample collected were included. Items from both scores were recorded. The performance of an AUS, the decision to admit the @entity1 , and the therapeutics were decided by the physician, disregarding the scores values. Nonadmitted @entity1 were contacted by telephone. RESULTS: Ninety-nine @entity1 were included. Mean age was 11 years, and 62.6% were males. Appendectomy was performed in 44.4% @entity1 . The area under the receiver operating characteristic curve for the Alvarado score was 0.96 and that for PAS was 0.97. Not a single @entity1 with an Alvarado score less than 5 or PAS less than 4 had @entity697 . All @entity1 with an Alvarado score greater than 8 or PAS greater than 7 had @entity697 . For both scores, the optimum cutoff point was 6 (sensibility of 90.4% and specificity of 91.2% for the Alvarado score and sensibility of 88.1% and specificity of 98.2% for PAS). Abdominal ultrasonography was performed on 31 @entity1 (sensibility of 84.6% and specificity of 94.4%). We studied the value of scores and AUS together. Assuming an Alvarado score from 1 to 4 and PAS from 1 to 3 as no @entity697 , an Alvarado score from 9 to 10 and PAS from 8 to 9 as @entity697 , and proceeding according to the AUS for intermediate values, a sensibility of 93.3% and 97.2% and a specificity of 100% and 97.6%, respectively, were obtained. CONCLUSIONS: Both scores are a useful tool in the evaluation of @entity1 with possible @entity697 . For extreme values of scores, the results really ensure their use in the emergency department. The AUS can help on decision making for intermediate values.
