An algorithm developed at Mayo Clinic Children’s Center in Rochester, Minnesota, significantly reduces the use of CT scans for children with suspected appendicitis without affecting diagnostic accuracy, according to a study published online in Surgery.
The study looked at 331 emergency-department pediatric patients (18 or younger) who underwent appendectomies for suspected appendicitis. Of the patients, 41 percent were treated in the two years before the algorithm was implemented and the rest during the three years after Mayo began using the algorithm. The rate of CT scans of the patients dropped by more than half—from 39 percent to 18 percent. The rate of cases that turned out not to be appendicitis—negative appendectomies, in other words—increased from 9 percent to 11 percent, but the study found that use of CT did not impact the risk of negative appendectomy.
Mayo created the algorithm collaboratively, “to come up with the best possible way of caring for the patients,” said Michael B. Ishitani, MD, an author of the study:
This algorithm was developed by a multidisciplinary group of pediatric emergency room physicians, pediatric surgeons, and radiologists to eliminate unnecessary exposure to radiation.
Dr. Ishitani is a professor of surgery at Mayo. He was quoted in a Mayo news release. The study was published June 19.
Overall, the study indicated that “decreasing the use of CT scans in these patients is both safe and cost-effective,” said Dr. Ishitani.
“Implementation of this algorithm across multiple centers is the ideal outcome of this study,” he said, “followed by further evaluations over time to ensure that the low rate of CT scan use continues.”
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