Validation of an electronic medical computer application to study acute appendicitis in paediatric patients

Abstract

DOI: 10.1016/j.rcpe.2016.02.003

Antecedents

The use of electronic medical record software for the diagnosis of the acute appendicitis has not been reported in our media.

Objective

To validate the use of medical record software, designed by the authors, that guides the management of patients with abdominal pain with suspected acute appendicitis.

Methodology

A prospective, longitudinal and observational study was performed in the Emergency Service of the Hospital Erasmo Meoz, between 30 May 2013, and May 2014, on patients between 5 and 14 years old, who came to the paediatric emergency department with acute abdominal pain and the general doctor suspected acute appendicitis.

Appendicitis was defined as the presence of a positive cytology report. Interobserver assessments were performed, and the sensitivity, specificity and the positive and negative value.

Results

Of 130 patients, 30 were excluded due to faulty inclusion criteria. The calculated kappa coefficient was 0.7 (95% confidence interval: 0.43-0.76). The cut-off points with the highest sensitivity were 1 and 2 (98.63% [95% CI; 92.6-99.7]), but with a specificity of 0% (95% CI; 0.0-12.4). The highest specificity was found between 9 and 10 (100% [95% CI; 43.8 - 100])), being the same for the lowest sensitivity (4.11% [CI 95%1.4-11.4]). By historic report, 100% of the operated patients had acute appendicitis.

Conclusions

The development of the electronic medical record software provides a valuable tool in the diagnostic process of a patient with pain, as it classifies patients with and without appendicitis