Algorithm Found to Reduce CT Scans for Diagnosis of Pediatric Appendicitis

Implementation of an algorithm designed to diagnose pediatric patients with suspected appendicitis reduces the utilization of computed tomography (CT) imaging scans, without affecting diagnostic accuracy.

The Mayo Clinic Children’s Center (Rochester, MN, USA) researchers published their study’s findings online June 19, 2014, in the journal Surgery. Acute appendicitis is the most typical cause of acute abdominal pain in children. CT scans are frequently utilized to detect acute appendicitis because they are widely available, effective, and have the ability to provide clinicians with advanced data in appendicitis cases suspected of complications.


However, CT scans are costly and expose patients to ionizing radiation. “This algorithm was developed by a multidisciplinary group of pediatric emergency room physicians, pediatric surgeons, and radiologists to eliminate unnecessary exposure to radiation,” clarified Michael B. Ishitani, MD, lead author of the study.

The study compared pediatric patients, under the age of 18, who underwent an appendectomy for acute appendicitis pre-algorithm implementation and post-implementation. Researchers evaluated 331 pediatric patients over the period of five years, and found that CT use decreased from 39% to 18% after the algorithm was employed.

Researchers discovered that when the algorithm was implemented, use of CT scans in patients dropped by over 50%, without affecting diagnostic effectiveness, validating that reducing the use of CT scans when evaluating patients for appendicitis is safe and cost-effective. “Implementation of this algorithm across multiple centers is the ideal outcome of this study, followed by further evaluations over time to ensure that the low rate of CT scan use continues,” commented Dr. Ishitani.


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