The main objective of this study is to evaluate the differences in accuracy of diagnosis between surgeons and surgical residents/ED physicians in patients with acute abdominal pain. In addition the influence of decisional tools for appendicitis and…
ID
Source
Brief title
Condition
- Other condition
Synonym
Health condition
aandoeningen geassocieerd met acute buikpijn
Research involving
Sponsors and support
Intervention
Outcome measures
Primary outcome
The primary outcome is the accuracy of diagnosis of surgeons, surgical
residents and ED physicians as well as the accuracy of diagnosis before and
after the use of decisional tools for suspected appendicitis and
diverticulitis.
Secondary outcome
Certainty of diagnosis before and after using decisional tools, accuracy of
diagnosis after using the standard imaging pathway, imaging resource
utilisation, length of stay in the Emergency department
levels WBC, CRP and Procalcitonin
Background summary
A common complaint in emergency medicine is acute abdominal pain. Because the
underlying condition can be life threatening, rapid work-up is needed to
establish an accurate diagnosis, including adequate choice of imaging
techniques. History taking and physical examination are highly
examiner-dependent, thus leading to the question: who is best to examine the
patient with acute abdominal pain? In current practice almost all patients are
examined by surgical residents or emergency department (ED) physicians. To our
knowledge, no papers studied the inter-examiner differences between surgeons
and residents/ED physicians in assessment of the (preliminary) diagnosis.
Decisional tools can enhance diagnostic accuracy. We developed evidence based
decisional tools for appendicitis and diverticulitis, since these are the most
common diagnoses in acute abdominal pain. Before the widespread use of these
decisional tools, their influence on accuracy and certainty of diagnosis must
be evaluated. Repeated laboratory tests are useful in diagnosing appendicitis.
However, the influence of repeated testing of WBC, CRP and procalcitonin on the
accuracy of diagnosis in acute abdominal pain is not clear. The predictive
value of procalcitonin in different common encountered diagnoses in acute
abdominal pain is also unclear.
Study objective
The main objective of this study is to evaluate the differences in accuracy of
diagnosis between surgeons and surgical residents/ED physicians in patients
with acute abdominal pain. In addition the influence of decisional tools for
appendicitis and diverticulitis on the accuracy of diagnosis will be assessed.
Secondary objectives include the evaluation of the influence of repeated
laboratory measurements on the accuracy of diagnosis and the predictive value
of procalcitonin for common diagnoses in acute abdominal pain.
Study design
This study is designed as a prospective cohort study.
Study burden and risks
No major risks or benefits are likely to be associated with participation in
this study. The burden for the patients consists of a surgeon performing an
additional physical examination and a single tap of blood.
Meibergdreef 9
1105 AZ Amsterdam
NL
Meibergdreef 9
1105 AZ Amsterdam
NL
Listed location countries
Age
Inclusion criteria
- Abdominal pain with a duration of more then 2 hours and less then 5 days
- Willing and able to give written informed consent
Exclusion criteria
- Age < 18 years
- Pregnancy
- Abdominal pain due to blunt of penetrating trauma
- Hemorrhagic shock due toe gastrointestinal bleeding or ruptured aortic aneurysm
Design
Recruitment
Followed up by the following (possibly more current) registration
No registrations found.
Other (possibly less up-to-date) registrations in this register
No registrations found.
In other registers
| Register | ID |
|---|---|
| CCMO | NL29165.018.09 |