@article{RN274,
   author = {Blok, G. and Burger, H. and van der Lei, J. and Berger, M. and Holtman, G.},
   title = {Development and validation of a clinical prediction rule for acute appendicitis in children in primary care},
   journal = {Eur J Gen Pract},
   volume = {29},
   number = {1},
   pages = {2233053},
   note = {1751-1402 Blok, Guus Orcid: 0000-0003-1654-6844 Burger, Huib Orcid: 0000-0001-6484-0349 van der Lei, Johan Orcid: 0000-0002-9203-3410 Berger, Marjolein Orcid: 0000-0001-6774-5961 Holtman, Gea Orcid: 0000-0001-6579-767x Journal Article England 2023/08/14 Eur J Gen Pract. 2023 Dec;29(1):2233053. doi: 10.1080/13814788.2023.2233053.},
   abstract = {BACKGROUND: Recognising acute appendicitis in children presenting with acute abdominal pain in primary care is challenging. General practitioners (GPs) may benefit from a clinical prediction rule. OBJECTIVES: To develop and validate a clinical prediction rule for acute appendicitis in children presenting with acute abdominal pain in primary care. METHODS: In a historical cohort study data was retrieved from GP electronic health records included in the Integrated Primary Care Information database. We assigned children aged 4-18 years presenting with acute abdominal pain (≤ 7 days) to development (2010-2012) and validation (2013-2016) cohorts, using acute appendicitis within six weeks as the outcome. Multiple logistic regression was used to develop a prediction model based on predictors with > 50% data availability derived from existing rules for secondary care. We performed internal and external temporal validation and derived a point score to stratify risk of appendicitis into three groups, i.e. low-risk, medium-risk and high-risk. RESULTS: The development and validation cohorts included 2,041 and 3,650 children, of whom 95 (4.6%) and 195 (5.3%) had acute appendicitis. The model included male sex, pain duration (<24, 24-48, > 48 h), nausea/vomiting, elevated temperature (≥ 37.3 °C), abnormal bowel sounds, right lower quadrant tenderness, and peritoneal irritation. Internal and temporal validation showed good discrimination (C-statistics: 0.93 and 0.90, respectively) and excellent calibration. In the three groups, the risks of acute appendicitis were 0.5%, 7.5%, and 41%. CONCLUSION: Combined with further testing in the medium-risk group, the prediction rule could improve clinical decision making and outcomes.},
   keywords = {Humans
Male
Child
*Clinical Decision Rules
Cohort Studies
*Appendicitis/diagnosis
Abdominal Pain/diagnosis/etiology
Acute Disease
Primary Health Care
Appendicitis
abdominal pain
clinical prediction rule ,
ISSN = 1381-4788 (Print) 1381-4788 ,
DOI = 10.1080/13814788.2023.2233053},
   year = {2023},
   type = {Journal Article}
}

{"_id":"nsrfxNmSNixDTMp8Z","bibbaseid":"blok-burger-vanderlei-berger-holtman-developmentandvalidationofaclinicalpredictionruleforacuteappendicitisinchildreninprimarycare-2023","author_short":["Blok, G.","Burger, H.","van der Lei, J.","Berger, M.","Holtman, G."],"bibdata":{"bibtype":"article","type":"Journal Article","author":[{"propositions":[],"lastnames":["Blok"],"firstnames":["G."],"suffixes":[]},{"propositions":[],"lastnames":["Burger"],"firstnames":["H."],"suffixes":[]},{"propositions":["van","der"],"lastnames":["Lei"],"firstnames":["J."],"suffixes":[]},{"propositions":[],"lastnames":["Berger"],"firstnames":["M."],"suffixes":[]},{"propositions":[],"lastnames":["Holtman"],"firstnames":["G."],"suffixes":[]}],"title":"Development and validation of a clinical prediction rule for acute appendicitis in children in primary care","journal":"Eur J Gen Pract","volume":"29","number":"1","pages":"2233053","note":"1751-1402 Blok, Guus Orcid: 0000-0003-1654-6844 Burger, Huib Orcid: 0000-0001-6484-0349 van der Lei, Johan Orcid: 0000-0002-9203-3410 Berger, Marjolein Orcid: 0000-0001-6774-5961 Holtman, Gea Orcid: 0000-0001-6579-767x Journal Article England 2023/08/14 Eur J Gen Pract. 2023 Dec;29(1):2233053. doi: 10.1080/13814788.2023.2233053.","abstract":"BACKGROUND: Recognising acute appendicitis in children presenting with acute abdominal pain in primary care is challenging. General practitioners (GPs) may benefit from a clinical prediction rule. OBJECTIVES: To develop and validate a clinical prediction rule for acute appendicitis in children presenting with acute abdominal pain in primary care. METHODS: In a historical cohort study data was retrieved from GP electronic health records included in the Integrated Primary Care Information database. We assigned children aged 4-18 years presenting with acute abdominal pain (≤ 7 days) to development (2010-2012) and validation (2013-2016) cohorts, using acute appendicitis within six weeks as the outcome. Multiple logistic regression was used to develop a prediction model based on predictors with > 50% data availability derived from existing rules for secondary care. We performed internal and external temporal validation and derived a point score to stratify risk of appendicitis into three groups, i.e. low-risk, medium-risk and high-risk. RESULTS: The development and validation cohorts included 2,041 and 3,650 children, of whom 95 (4.6%) and 195 (5.3%) had acute appendicitis. The model included male sex, pain duration (<24, 24-48, > 48 h), nausea/vomiting, elevated temperature (≥ 37.3 °C), abnormal bowel sounds, right lower quadrant tenderness, and peritoneal irritation. Internal and temporal validation showed good discrimination (C-statistics: 0.93 and 0.90, respectively) and excellent calibration. In the three groups, the risks of acute appendicitis were 0.5%, 7.5%, and 41%. CONCLUSION: Combined with further testing in the medium-risk group, the prediction rule could improve clinical decision making and outcomes.","keywords":"Humans Male Child *Clinical Decision Rules Cohort Studies *Appendicitis/diagnosis Abdominal Pain/diagnosis/etiology Acute Disease Primary Health Care Appendicitis abdominal pain clinical prediction rule , ISSN = 1381-4788 (Print) 1381-4788 , DOI = 10.1080/13814788.2023.2233053","year":"2023","bibtex":"@article{RN274,\r\n author = {Blok, G. and Burger, H. and van der Lei, J. and Berger, M. and Holtman, G.},\r\n title = {Development and validation of a clinical prediction rule for acute appendicitis in children in primary care},\r\n journal = {Eur J Gen Pract},\r\n volume = {29},\r\n number = {1},\r\n pages = {2233053},\r\n note = {1751-1402 Blok, Guus Orcid: 0000-0003-1654-6844 Burger, Huib Orcid: 0000-0001-6484-0349 van der Lei, Johan Orcid: 0000-0002-9203-3410 Berger, Marjolein Orcid: 0000-0001-6774-5961 Holtman, Gea Orcid: 0000-0001-6579-767x Journal Article England 2023/08/14 Eur J Gen Pract. 2023 Dec;29(1):2233053. doi: 10.1080/13814788.2023.2233053.},\r\n abstract = {BACKGROUND: Recognising acute appendicitis in children presenting with acute abdominal pain in primary care is challenging. General practitioners (GPs) may benefit from a clinical prediction rule. OBJECTIVES: To develop and validate a clinical prediction rule for acute appendicitis in children presenting with acute abdominal pain in primary care. METHODS: In a historical cohort study data was retrieved from GP electronic health records included in the Integrated Primary Care Information database. We assigned children aged 4-18 years presenting with acute abdominal pain (≤ 7 days) to development (2010-2012) and validation (2013-2016) cohorts, using acute appendicitis within six weeks as the outcome. Multiple logistic regression was used to develop a prediction model based on predictors with > 50% data availability derived from existing rules for secondary care. We performed internal and external temporal validation and derived a point score to stratify risk of appendicitis into three groups, i.e. low-risk, medium-risk and high-risk. RESULTS: The development and validation cohorts included 2,041 and 3,650 children, of whom 95 (4.6%) and 195 (5.3%) had acute appendicitis. The model included male sex, pain duration (<24, 24-48, > 48 h), nausea/vomiting, elevated temperature (≥ 37.3 °C), abnormal bowel sounds, right lower quadrant tenderness, and peritoneal irritation. Internal and temporal validation showed good discrimination (C-statistics: 0.93 and 0.90, respectively) and excellent calibration. In the three groups, the risks of acute appendicitis were 0.5%, 7.5%, and 41%. CONCLUSION: Combined with further testing in the medium-risk group, the prediction rule could improve clinical decision making and outcomes.},\r\n keywords = {Humans\r\nMale\r\nChild\r\n*Clinical Decision Rules\r\nCohort Studies\r\n*Appendicitis/diagnosis\r\nAbdominal Pain/diagnosis/etiology\r\nAcute Disease\r\nPrimary Health Care\r\nAppendicitis\r\nabdominal pain\r\nclinical prediction rule ,\r\nISSN = 1381-4788 (Print) 1381-4788 ,\r\nDOI = 10.1080/13814788.2023.2233053},\r\n year = {2023},\r\n type = {Journal Article}\r\n}\r\n\r\n","author_short":["Blok, G.","Burger, H.","van der Lei, J.","Berger, M.","Holtman, G."],"key":"RN274","id":"RN274","bibbaseid":"blok-burger-vanderlei-berger-holtman-developmentandvalidationofaclinicalpredictionruleforacuteappendicitisinchildreninprimarycare-2023","role":"author","urls":{},"keyword":["Humans Male Child *Clinical Decision Rules Cohort Studies *Appendicitis/diagnosis Abdominal Pain/diagnosis/etiology Acute Disease Primary Health Care Appendicitis abdominal pain clinical prediction rule","ISSN = 1381-4788 (Print) 1381-4788","DOI = 10.1080/13814788.2023.2233053"],"metadata":{"authorlinks":{}},"html":""},"bibtype":"article","biburl":"https://bibbase.org/network/files/qwipow2DJsAxqNp83","dataSources":["PJSqX8FMpCPRdw3CQ","qLDnCcKM9omXNrRY8","TB9sD3avjy7bNxfgS","vDmJPYmHEKAT3tMNL","PcZMFHooKwpboi2he","jZMXEeHTfokmisJDv"],"keywords":["humans male child *clinical decision rules cohort studies *appendicitis/diagnosis abdominal pain/diagnosis/etiology acute disease primary health care appendicitis abdominal pain clinical prediction rule","issn = 1381-4788 (print) 1381-4788","doi = 10.1080/13814788.2023.2233053"],"search_terms":["development","validation","clinical","prediction","rule","acute","appendicitis","children","primary","care","blok","burger","van der lei","berger","holtman"],"title":"Development and validation of a clinical prediction rule for acute appendicitis in children in primary care","year":2023}