Usefulness of qSOFA and ECOG Scores for Predicting Hospital Mortality in Postsurgical Cancer Patients without Infection

Background. The quick sequential organ failure assessment (qSOFA) and the Eastern Cooperative Oncologic Group (ECOG) scale are simple and easy parameters to measure because they do not require laboratory tests. The objective of this study was to compare the discriminatory capacity of the qSOFA and ECOG to predict hospital mortality in postsurgical cancer patients without infection. Methods. During the period 2013–2017, we prospectively collected data of all patients without infection who were admitted to the ICU during the postoperative period, except those who stayed in the ICU for <24 hours or patients under 18 years. The ECOG score during the last month before hospitalization and the qSOFA performed during the first hour after admission to the intensive care unit (ICU) were collected. The primary outcome for this study was the in-hospital mortality rate. Results. A total of 315 patients were included. The ICU and hospital mortality rates were 6% and 9.2%, respectively. No difference was observed between the qSOFA [AUC=0.75 (95% CI = 0.69-0.79)] and the ECOG scores [AUC=0.68 (95%CI =0.62-0.73)] (p=0.221) for predicting in-hospital mortality. qSOFA greater than 1 predicted in-hospital mortality with a high sensitivity (100%) but low specificity (38.8%); positive predictive value of 26.3% and negative predictive value of 93.1% compared to 74.4% of specificity, 55.1% of sensitivity%; positive predictive value of 18% and negative predictive value of 94.2% for an ECOG score greater than 1. Multivariable Cox regression analysis identified two independent predicting factors of in-hospital mortality, which included ECOG score during the last month before hospitalization (HR: 1.46; 95 % CI: 1.06-2.00); qSOFA calculated in the first hours after ICU admission (OR: 3.17; 95 % CI: 1.79–5.63). Conclusion. No difference was observed between the qSOFA and ECOG for predicting in-hospital mortality. The qSOFA score performed during the first hour after admission to the ICU and ECOG scale during the last month before hospitalization were associated with in-hospital mortality in postsurgical cancer patients without infection. The qSOFA and ECOG score have a potential to be included as early warning tools for hospitalized postsurgical cancer patients without infection.

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Evaluating Specivity, Sensitivity, Positive and Negative Predictive Values of CA125 for Diagnosing Ovarian Cancer

Journal of Arak University of Medical Sciences ◽

10.32598/jams.24.2.6002.1 ◽

2021 ◽

Vol 24 (2) ◽

pp. 196-203

Author(s):

Elahe Fini ◽

◽

Neda Nasirian ◽

Bahram Hosein Beigy ◽

◽

...

Keyword(s):

Ovarian Cancer ◽

Positive Predictive Value ◽

Tumor Marker ◽

Negative Predictive Value ◽

Predictive Value ◽

Screening Test ◽

High Sensitivity ◽

Medical Community ◽

Cross Sectional ◽

Predictive Values

Background and Aim: Ovarian cancer is among the most common cancers in women worldwide. CA125 is the most frequent biomarker used in the screening for ovarian cancer. CA125 has no high sensitivity and specificity as a screening test in the medical community; however, because of being simple and noninvasive, it is almost always requested for evaluation and ruling out cancer. It plays an important role in the treatment and post-treatment process, the prediction of prognosis, and the relapse of the disease. The present study aimed to determine the relationship between a high level of CA125 tumor marker and ovarian cancer by detecting spesivity, sensivity, positive and negative predictive values. Methods & Materials: In this cross-sectional study, all cases undergoing CA125 test in Velayat Hospital in 2017-1028 were evaluated for having ovarian cancer. In addition, the CA125 level was compared between healthy individuals and patients with ovarian cancer. Finally, the obtained data were analyzed using SPSS. Ethical Considerations: The present study was approved by the Qazvin University of Medical Sciences (Ethics Code: IR.QUMS.REC.1396.316). Results: In this study, 35.3% of the study participants received a definite diagnosis of ovarian cancer. Generally, CA125 values were negative in 41.8% and positive in.58.2% of the study subjects. The sensitivity of the test was measured as 80.1%, the specivity as 53.6%, the positive predictive value equaled 48.4%, and the negative predictive value was measured as 83%. There was a significant relationship between age and the presence of ovarian cancer, and serum CA125 levels. Conclusion: The present study suggested that age and the serum level of CA125 were statistically significant. Finally, CA125 levels were significantly related to ovarian cancer. It provided moderate specivity and specivity as well as low positive predictive value and high negative predictive value as a tumor marker; it is valuable for ruling out of tumor but not appropriate as a screening test.

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Isolated demyelinating syndromes: comparison of CSF oligoclonal bands and different MR imaging criteria to predict conversion to CDMS

Multiple Sclerosis Journal ◽

10.1177/135245850100700603 ◽

2001 ◽

Vol 7 (6) ◽

pp. 359-363 ◽

Cited By ~ 62

Author(s):

M Tintoré ◽

A Rovira ◽

L Brieva ◽

E Grivé ◽

R Jardí ◽

...

Keyword(s):

Mr Imaging ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

High Sensitivity ◽

Oligoclonal Bands ◽

High Negative Predictive Value ◽

Csf Oligoclonal Bands ◽

Sensitivity Specificity

Aim of the study: To evaluate and compare the capacity of oligoclonal bands (OB) and three sets of MR imaging criteria to predict the conversion of clinically isolated syndromes (CIS) to clinically definite multiple sclerosis (CDMS). Patients and methods: One hundred and twelve patients with CIS were prospectively studied with MR imaging and determination of OB. Based on the clinical follow-up (conversion or not conversion to CDMS), we calculated the sensitivity, specificity accuracy, positive and negative predictive value of the OB, and MR imaging criteria proposed by Paty et al, Fazekas et al and Barkhof et al. Results: CDMS developed in 26 (23.2%) patients after a mean follow-up of 31 months (range 12-62). OB were positive in 70 (62.5%) patients and were associated with a higher risk of developing CDMS. OB showed a sensitivity of 81%, specificity of 43%, accuracy of 52%, positive predictive value (PPV) of 30% and negative predictive value (NPV) of 88%. Paty and Fazekas criteria showed the same results with a sensitivity of 77%, specificity of 51%, accuracy of 57%, positive predictive value of 32% and negative predictive value of 88%. Barkhof criteria showed a sensitivity of 65%, specificity of 70%, accuracy of 69%, PPV of 40% and NPV of 87%. The greatest accuracy was achieved when patients with positive OB and three or four Barkhof's criteria were selected. Conclusions: We observed a high prevalence of OB in CIS. OB and MR imaging (Paty's and Fazekas' criteria) have high sensitivity. Barkhof's criteria have a higher specificity. Both OB and MR imaging criteria have a high negative predictive value.

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Procalcitonin and C-Reactive Protein/Procalcitonin Ratio as Markers of Infection in Patients With Solid Tumors

Frontiers in Medicine ◽

10.3389/fmed.2021.627967 ◽

2021 ◽

Vol 8 ◽

Author(s):

Matteo Vassallo ◽

Celine Michelangeli ◽

Roxane Fabre ◽

Sabrina Manni ◽

Pierre L. Genillier ◽

...

Keyword(s):

Positive Predictive Value ◽

Cancer Patients ◽

Negative Predictive Value ◽

Solid Tumors ◽

Predictive Value ◽

C Reactive Protein ◽

Reactive Protein ◽

Documented Infection ◽

Baseline Levels ◽

Sensitive Marker

Objectives: The roles of procalcitonin (PCT) and C-reactive protein (CRP) in febrile cancer patients is currently unclear. Our aim was to assess these in febrile patients with solid tumors and to identify cut-off values for ruling out infection.Methods: We retrospectively evaluated patients with solid tumors admitted to hospital due to fever. They were divided into those with Fever with microbiologically documented infection (FMDI), Fever with clinically documented infection (FCDI) and Tumor-related fever (TRF). PCT and CRP levels were compared. Receiver-operating curves were plotted to define the best cut-off values for discriminating between infection-related and cancer-related fever.Results: Between January 2015 to November 2018, 131 patients were recorded (mean age 68 years, 67% male, 86% with metastasis). Patients with FMDI or FCDI had significantly higher baseline levels of PCT and lower CRP/PCT than those with TRF. A PCT cut-off value of 0.52 ng/mL for discriminating between infection and cancer-associated fever yielded 75% sensitivity, 55% specificity, 77% positive predictive value (PPV), and 52% negative predictive value (NPV). A CRP/PCT ratio with a cut-off value of 95 showed 56% sensitivity, 70% specificity, 79% NPV, and 44% PPV.Discussion: PCT is a sensitive marker of sepsis or localized infection in patients with solid tumors, but its specificity is poor. The CRP/PCT ratio improves specificity, thus providing a reliable means of ruling out infection for values above 95.

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Role of imprint cytology in thoracic endoscopy suite

Egyptian Journal of Bronchology ◽

10.1186/s43168-020-00025-y ◽

2020 ◽

Vol 14 (1) ◽

Author(s):

Mohammed Elsaid Hantera ◽

Salwa Atef Ganna ◽

Ayman Mohamed Elsaka ◽

Walaa Mowafy El-Lawaty

Keyword(s):

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

Fiberoptic Bronchoscopy ◽

High Sensitivity ◽

Added Value ◽

Imprint Cytology ◽

Medical Thoracoscopy ◽

Multiple Biopsies ◽

Sensitivity Specificity

Abstract Background Fiberoptic bronchoscopy and medical thoracoscopy are basic interventional modalities for the diagnosis of a wide variety of pleuropulmonary diseases. In some cases, we need fast and accurate results for decision-making. We aimed to evaluate the diagnostic accuracy of imprint cytology and its added value to the pulmonologist. Results Multiple biopsies were taken from 54 patients included 31 patients with lung masses subjected to fiberoptic bronchoscopy and 23 patients with undiagnosed exudative pleural effusion subjected to medical thoracoscopy. Imprint cytology was done to all biopsies which are later examined histopathologically. Regarding fiberoptic bronchoscopy biopsies, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of imprint cytology were 93.33, 100, 100, 33.33, and 93.55%, respectively. While in medical thoracoscopy biopsies, the sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and accuracy of imprint cytology were 94.74, 100, 100, 80, and 95.65%, respectively. Conclusion Imprint cytology is an easy, rapid, and reliable method that has a high sensitivity and specificity in the diagnosis of lung and pleural malignancies compared with histopathology.

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Diagnostic Test On Modified Score Of Cesarean Section History In Placenta Accreta Index In Predicting Placenta Accreta Diagnosis In Rsup Dr M Djamil

JOURNAL OBGIN EMAS ◽

10.25077/aoj.5.2.215-230.2021 ◽

2021 ◽

Vol 5 (2) ◽

pp. 215-230

Author(s):

Widayat Widayat ◽

Andi Friadi ◽

Hafni Bacthiar

Keyword(s):

Caesarean Section ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Diagnostic Test ◽

Predictive Value ◽

Placenta Accreta ◽

High Sensitivity ◽

Kappa Score ◽

Chorionic Villi ◽

History Of

Introduction : Placenta accreta is defined as abnormal implantation of placenta villi which invades myometrium without the presence of decidua bacalis resulting in placenta that is difficult to remove. Based on the depth of invasion, placenta accreta is divided into three grades, placenta accreta, placenta increta, and placenta percreta. Placenta accreta developes if chorionic villi attaches to endometrium beyond desidua basalis. Placenta increta develops when chorionic villi invades the whole myometrium. Placenta percreta developes when chorionic villi attaches beyond myometrium reaching serous and abdominal organ. Based on clinical manifestation, placenta accreta is the common term being used. Incident of abnormal placenta invasion varies from 1 : 93.000 up to 1 : 540 pregnancy. PA incidence had increased four times from 1994 to 2002 in line with increased of caesarean section procedure. Other study showed history of caesarean section increased risk of placenta accreta up to 8,7 times. Placenta accreta index (PAI) was developed based on scoring process or various parameters assessment to help diagnose placenta accreta. The parameters including: history of caesarean section ≥ 2 times, lacunae grade, sagittal smallest myometrial thickness, anterior placenta previa and birding vessel. High PAI indicates high risk of abnormal placenta invasion based on histology.Objective : This study aims to investigate modified history of cesarean section score in placenta accreta index in predicting placenta accreta diagnosis in RSUP DR M Djamil Padang.Material and methods : This was analytical study with cross sectional design. Study population was 84 placenta accreta patients in RSUP Dr. M. Djamil Padang from 2016 to 2019. Study sample was recruited using simple random sampling technique after meeting inclusion and exclusion criteria. Statistic analysis was done using Cohen’s Kappa test. Diagnostic test including sensiticivy, specivicity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy.Result : Strenght of agreement diagnosis placenta accreta based on PAI showed Kappa score of -0,002 (Kappa score < 0,2) which indicated poor strength of agreement. Strenght of agreement diagnosis placenta accreta based on modified PAI showed Kappa score of 0,353 (Kappa score range from 0,21 to 0,40) which indicated fair strength of agreement. PAI diagnostic test yield sensitivity of 97,1%, specificity of 2,8%, positive predictive value of 48,5%, negative predictive value of 50%, and accuracy of 48,6%. Modified PAI diagnostic test yield sensitivity of 97,1%, specificity of 38,9%, positive predictive value of 60%, negative predictive value of 93,3%, and accuracy of 67,1%.Conclusion : PAI has high sensitivity, low specificity, moderate positive predictive value, moderate negative predictive value, and moderate accuration. Modified PAI has high sensitivity, moderate specificity, moderate positive predictive value, high negative predictive value, and high accuracy. PAI diagnosis has poor strength of agreement compared with pathology anatomy. Modified PAI diagnosis has fair strength of agreement compared with pathology anatomy. Modified PAI has identical sensitivity with standard PAI, meanwhile for specificity, positive predictive value, negative predictive value, and accuracy, modified PAI yields higher result compared to PAI.Keywords: Modified score of history caesarean section, placenta accreta index, Modified placenta accreta index, diagnostic test of placenta accreta diagnosis

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Sensitivity and Specificity of Gene Xpert in the Diagnosis of Spinal Tuberculosis: A Prospective Controlled Clinical Study

Global Spine Journal ◽

10.1177/2192568219858310 ◽

2019 ◽

Vol 10 (5) ◽

pp. 553-558

Author(s):

Anil M. Solanki ◽

Saumyajit Basu ◽

Amitava Biswas ◽

Subhendu Roy ◽

Aditya Banta

Keyword(s):

Positive Predictive Value ◽

Negative Predictive Value ◽

Sensitivity And Specificity ◽

Predictive Value ◽

Spinal Tuberculosis ◽

False Negative ◽

High Sensitivity ◽

Control Group ◽

Surgical Biopsy ◽

True Negative

Study Design: Prospective matched cohort study Objective: To evaluate the sensitivity and specificity of Gene Xpert in the diagnosis of spinal tuberculosis. Methods: From January 2016 to August 2018, Gene Xpert results were prospectively studied in 68 patients of clinicoradiologically suspected spinal tuberculosis (STB) and a control group (CG) of 92 patients, all of whom underwent computed tomography–guided/C-arm-guided/open surgical biopsy. Sensitivity, specificity, positive predictive value, and negative predictive value are obtained using standard equations. Results: Out of 68 cases of STB, Gene Xpert was positive in 62 (true positive: 62/68) and negative in 6 (false negative: 6/68). Gene Xpert was negative for all 92 cases of CG (true negative: 92/92, false positive 0/92). Thus, in our series, sensitivity of Gene Xpert is 91.18%, specificity is 100%, positive predictive value is 100%, and negative predictive value is 93.88%. Out of all cases of STB, 62/68 (91.18%) were Gene Xpert positive, but only 35/64 (54.69%) was acid-fast bacilli (AFB) culture positive and 53/60(88.33%) was histopathologically conclusive of TB. Also, Gene Xpert was positive in 7/7 (100%) cases of STB in which histopathology were inconclusive and 25/29 (86.21%) cases of STB in which AFB culture was negative. Conclusion: In STB, Gene Xpert clearly outperforms AFB culture and histopathology due to its high sensitivity and specificity apart from being rapid in diagnosis. Hence it is justified to diagnose spinal tuberculosis by Gene Xpert though histopathology is confirmative and AFB culture remains the gold standard.

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Myocardial injury is associated with in-hospital mortality of confirmed or suspected COVID-19 in Wuhan, China: A single center retrospective cohort study

10.1101/2020.03.21.20040121 ◽

2020 ◽

Cited By ~ 13

Author(s):

Fan Zhang ◽

Deyan Yang ◽

Jing Li ◽

Peng Gao ◽

Taibo Chen ◽

...

Keyword(s):

Risk Factors ◽

Hospital Mortality ◽

Cardiac Troponin ◽

Troponin I ◽

Cox Regression ◽

Cardiac Injury ◽

High Sensitivity ◽

Hospital Death ◽

Cox Regression Analysis ◽

D Dimer

AbstractBackgroundSince December 2019, a cluster of coronavirus disease 2019 (COVID-19) occurred in Wuhan, Hubei Province, China and spread rapidly from China to other countries. In-hospital mortality are high in severe cases and cardiac injury characterized by elevated cardiac troponin are common among them. The mechanism of cardiac injury and the relationship between cardiac injury and in-hospital mortality remained unclear. Studies focused on cardiac injury in COVID-19 patients are scarce.ObjectivesTo investigate the association between cardiac injury and in-hospital mortality of patients with confirmed or suspected COVID-19.MethodsDemographic, clinical, treatment, and laboratory data of consecutive confirmed or suspected COVID-19 patients admitted in Wuhan No.1 Hospital from 25th December, 2019 to 15th February, 2020 were extracted from electronic medical records and were retrospectively reviewed and analyzed. Univariate and multivariate Cox regression analysis were used to explore the risk factors associated with in-hospital death.ResultsA total of 110 patients with confirmed (n=80) or suspected (n=30) COVID-19 were screened and 48 patients (female 31.3%, mean age 70.58±13.38 year old) among them with high-sensitivity cardiac troponin I (hs-cTnI) test within 48 hours after admission were included, of whom 17 (17/48, 35.4%) died in hospital while 31 (31/48, 64.6%) were discharged or transferred to other hospital. High-sensitivity cardiac troponin I was elevated in 13 (13/48, 27.1%) patents. Multivariate Cox regression analysis showed pulse oximetry of oxygen saturation (SpO2) on admission (HR 0.704, 95% CI 0.546-0.909, per 1% decrease, p=0.007), elevated hs-cTnI (HR 10.902, 95% 1.279-92.927, p=0.029) and elevated d-dimer (HR 1.103, 95%CI 1.034-1.176, per 1mg/L increase, p=0.003) on admission were independently associated with in-hospital mortality.ConclusionsCardiac injury defined by hs-cTnI elevation and elevated d-dimer on admission were risk factors for in-hospital death, while higher SpO2 could be seen as a protective factor, which could help clinicians to identify patients with adverse outcome at the early stage of COVID-19.

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Role of Hematological Score in Early Diagnosis of Neonatal Sepsis

Chattagram Maa-O-Shishu Hospital Medical College Journal ◽

10.3329/cmoshmcj.v18i2.47776 ◽

2020 ◽

Vol 18 (2) ◽

pp. 45-48

Author(s):

Dipika Dey ◽

Razia Sulltana ◽

Wazir Ahmed ◽

Mahmood Ahmed Chowdhury ◽

Farhana Akter ◽

...

Keyword(s):

Blood Culture ◽

Early Diagnosis ◽

Positive Predictive Value ◽

Negative Predictive Value ◽

Neonatal Sepsis ◽

Predictive Value ◽

High Sensitivity ◽

High Specificity ◽

Hematological Parameter ◽

Total Leukocyte Count

Background: Neonatal sepsis is one of the major causes of morbidity & mortality in the newborn, more so in the developing countries. Objective: The objective of this study was to evaluate the applicability of Haematological Scoring System (HSS) in early diagnosis of sepsis and its compatibility with C-reactive protein (CRP) and blood culture. Materials and methods: This prospective study consisted of 205 neonates admitted at neonatal intensive care unit of Chattogram Maa-shishu-o General Hospital with clinical suspicion of neonatal sepsis, from July 2017 to December 2017. The neonatal hematological parameter was measured in all cases. Blood culture and CRP estimation were also performed. Blood culture is considered as gold standard for diagnosis of sepsis. Score 3 and more was considered as positive Results: Out of 205 neonates of our study population, forty one (20%) had proven sepsis according to culture. Total leukocyte count showed high sensitivity & least specificity, immature to mature neutrophil ratio showed high sensitivity and high specificity. Platelet count showed high negative predictive value and least positive predictive value. The HSS was found to have a sensitivity of 82.9%, specificity of 79.8%, positive predictive value was 50.74% and negative predictive value was 94.92%. Considering the high sensitivity and negative predictive value, this study implies that score ³3 were more reliable as a screening tool for sepsis than any of the individual hematological parameter. Conclusion: HSS is a simple, easy and rapid adjunct for the diagnosis of clinically suspected cases of neonatal sepsis. It also provides an effective guideline to make decisions regarding judicious use of antibiotic therapy. Chatt Maa Shi Hosp Med Coll J; Vol.18 (2); July 2019; Page 45-48

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The sensitivity and specificity of rapid diagnostic test for malaria parasite in comparison to slide microscopy as gold standard

UIC Research Journal ◽

10.17158/522 ◽

2016 ◽

Vol 19 (2) ◽

Author(s):

John Mark De Real

Keyword(s):

Positive Predictive Value ◽

Negative Predictive Value ◽

Diagnostic Test ◽

Rapid Diagnostic Test ◽

Sensitivity And Specificity ◽

Predictive Value ◽

Gold Standard ◽

Malaria Parasite ◽

High Sensitivity ◽

Significant Difference

<p>The main objective of this study was to test the sensitivity and specificity of rapid diagnostic test for malaria parasite in comparison to slide microscopy as gold standard. Data were acquired from blood mass survey of malaria infection conducted in the community of Paquibato district, Davao City. There were 377 total participants examined through Rapid Diagnostic Test (RDT) and slide microscopy. Of the 377 participants tested, 16 (4.24%) of them were positive to Plasmodium falciparum and 68 (18.04%) were positive to Plasmodium vivax using slide microscopy. Of the 16 participants’ positive for P. faciparum, PfRDT (HRP-2) correctly identified 13 expressing 81.25% (low) sensitivity of the tool. Of the 68 participants’ positive for P. vivax, PvRDT (pLDH) correctly identified 65 expressing 95.59% (high) sensitivity. Both of the RDTs (HRP-2 and pLDH), however, attained 100% specificity. PfRDT (HRP-2) has a positive predictive value of 100% and a negative predictive value of 99.2%, likewise PvRDT (pLDH) has a positive predictive value of 100% and a negative predictive value of 99.04%, all in all, suggesting a high degree of reliability of SD BIOLINE Malaria Antigen P.f/P.v. the data showed no significant difference on the performance level of RDT, albeit less sensitive, compared to slide microscopy.</p><p><strong>Keywords:</strong> Health, malaria, sensitivity, specificity, HRP-2, pLDH, descriptive Davao City, Philippines.</p><div> </div>

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MODIFIED ALVARADO SCORE IN CHILDREN WITH DIAGNOSIS OF APPENDICITIS

ABCD Arquivos Brasileiros de Cirurgia Digestiva (São Paulo) ◽

10.1590/0102-6720201700010014 ◽

2017 ◽

Vol 30 (1) ◽

pp. 51-52 ◽

Cited By ~ 4

Author(s):

Mehran PEYVASTEH ◽

Shahnam ASKARPOUR ◽

Hazhir JAVAHERIZADEH ◽

Sepideh BESHARATI

Keyword(s):

Positive Predictive Value ◽

Negative Predictive Value ◽

Predictive Value ◽

High Sensitivity ◽

Scoring Systems ◽

Negative Appendectomy ◽

Alvarado Score ◽

Rebound Tenderness ◽

Modified Alvarado Score ◽

Sensitivity Specificity

ABSTRACT Background: Appendicitis is one of the most common abdominal emergency. Some predictive scoring systems are recommended to decrease the rate of negative appendectomy. Aim: To evaluate sensitivity, specificity, positive predictive value, and negative predictive value of modified Alvarado score in children who underwent appendectomy. Methods: Four hundred children with initial diagnosis of appendicitis were randomly selected from patients who underwent appendectomy. Modified Alvarado score was used for evaluation of the appendicitis, that was confirmed using histology. Results: Of modified Alvarado score components, anorexia; nausea and vomiting and rebound tenderness were significantly more common in children with positive appendectomy in contrast to patients with negative appendectomy. Sensitivity, specificity, positive predictive value, and negative predictive value for modified Alvarado score were: 91.3%; 38.4%; 87.7%; and 51.2% respectively. Conclusion: Alvarado score has high sensitivity but low specificity for diagnosis of acute appendicitis in children.

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