An Appendicitis Risk Calculator: A New Diagnostic Tool at the Cutting Edge :

We are always looking for a way to maximize our clinical decision making using our history-taking, physical exam, and laboratory and imaging studies to determine who might have appendicitis. This week Kharbanda et al. (10.1542/peds.2017-2699) present a validation study of a “clinical calculator” that was derived from 9 emergency departments and more than 2400 children of which 40% had appendicitis. The validity of the derived score was then tested in a single emergency department involving more than 1400 children both pre and post the development of this calculator of which 35% had appendicitis.  The investigators used a variety of variables including age, gender, temperature, nausea/vomiting, descriptors regarding the pain, and white blood cell counts to create a “pediatric Appendicitis Risk Calculator: (pARC) which was then compared to another scoring system the Pediatric Appendicitis Score.  As you will see as you read through the results of this study, the pARC score performed better than the Pediatric Appendicitis Score. Are you using a score system to make your diagnosis of appendicitis?  If so, would you use this new scoring system instead of one you were using previously?  We encourage you to explore the findings in this study and excise the information that suggests that this new scoring tool is one worth using the next time you have a patient whose abdominal pain is suspicious for appendicitis.