Is Alvarado Score Helpful for Pediatrician in Diagnosis of Acute Appendicitis? Our Center Experience

Background: Many problems in the diagnosis of patients with suspected appendicitis have led to the design of clinical scoring systems. In children, diagnostics tools for appendicitis are more critical. Younger patients, diagnostic challenges become more. Practical scoring systems are useful without any particular material and necessitate novel ability. Objectives: However, in spite of the reported outstanding consequences, these scoring systems are not employed regularly. Methods: In this cross-sectional study performed from October 2016 to October 2017, ten provinces out of the 31 provinces in Iran were randomly selected. A total of 631 patients referring to the hospitals with the suspicion of acute appendicitis were assessed. Related variables such as age, sex, right lower quadrant (RLQ) pain, migration of pain to RLQ, nausea, and presence of vomiting, anorexia, tenderness in RLQ and guarding, presence of rebound tenderness, and degree of fever were taken from recorded files by pediatricians. Alvarado scoring system was used for included cases to assess the accuracy of this test for diagnosis of appendicitis in our centers. Results: The mean age of eligible patients was 9.3 ± 3.21 years ranged from 3 years to 18 years, and 380 (60.5%) were male. Using the Alvarado score system in this study, considering the cut-off point value of 7 to decide for operation, the positive predictive value (PPV) showed 32.6%, and negative predictive value (NPV) was 76.73%, with a sensitivity of 44.05% and, specificity of 66.95%. There were statistically no significant correlations among the scoring of the Alvarado and diagnosis of AA (P < 0.05). Regarding receiver operator characteristic curves (ROC), the area under curve (AUC) was 0.58 (0.54 to 0.63) for Alvarado. The AUC was very low, so there was no value for the diagnosis of appendicitis. According to the findings of the present study, the cut-off point of 4.5 is suggested for the diagnosis of acute appendicitis in children with a sensitivity of 73% and specificity of 58%. Conclusions: Although the Alvarado scores supply obviously practical diagnostic information in the management of pediatric population with supposed appendicitis, this method delivers no adequate PPV for clinical practice as a safe way for determining necessary operation.

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Advantage of ultrasonography in the diagnosis of acute appendicitis at Al-Karama Teaching Hospital

International Surgery Journal ◽

10.18203/2349-2902.isj20190467 ◽

2019 ◽

Vol 6 (3) ◽

pp. 702

Author(s):

Mohammed Hillu Surriah ◽

Amine Mohammed Bakkour ◽

Nidaa Ali Abdul Hussain

Keyword(s):

Acute Appendicitis ◽

Teaching Hospital ◽

Predictive Value ◽

Diagnostic Technique ◽

Cost Effective ◽

Cross Sectional Study ◽

Negative Appendectomy ◽

Cross Sectional ◽

Suspected Appendicitis ◽

Presenting Symptoms

Background: The clinical diagnosis of acute appendicitis remains a challenge to surgeons. Different aids were introduced to improve the diagnostic accuracy. Among these modalities, ultrasonography is simple, easily available, non-invasive, convenient and cost effective. The aim of the study was to determine the validity of ultrasound in diagnosis of the acute appendicitis in those with clinically diagnosed patients.Methods: A cross sectional study was carried out in Al-Karama teaching hospital for thirty months from the period of 1st June 2016 to 1st December 2018. All patients with suspected appendicitis underwent clinical evaluation then sent for US. Results of surgeries, where relevant, were compared against US results. Positive and negative appendices on histopathology were regarded in accordance to the criteria which was negative appendectomy was defined as normal looking appendix and absence of acute inflammation on histopathology while positive cases included appendices showing acute inflammatory changes. Sensitivity, specificity and overall accuracy was calculated.Results: A total of 435 patients with suspected appendicitis, males 224 (51.49%) and females 211 (48.50%) were included in present study. There were no significant differences between patients with positive and negative histopathology findings regarding presenting symptoms. There was a significant association between (cough sign, localized tenderness sign and pointing sign) and patients with positive histopathology findings. Regarding to the validity results of ultrasound in comparison to histopathology findings were accuracy 87.6%, sensitivity 87.8%, specificity 85.3%, positive predictive value 98.6% and negative predictive value 62.8%.Conclusions: The ultrasonography had a good accuracy, sensitivity and specificity in diagnosing acute appendicitis cases. Negative with ultrasonography results should be re-examined with different diagnostic technique like CT-scan.

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A comparison of Tzanakis and Alvarado scoring system in the diagnosis of acute appendicitis

International Surgery Journal ◽

10.18203/2349-2902.isj20192370 ◽

2019 ◽

Vol 6 (6) ◽

pp. 2080

Author(s):

R. Anupriya ◽

C. P. Ganesh Babu ◽

K. V. Rajan

Keyword(s):

Acute Appendicitis ◽

Predictive Value ◽

Scoring System ◽

Histopathological Examination ◽

Cross Sectional Study ◽

Alvarado Score ◽

Cross Sectional ◽

Abdominal Emergency ◽

Gandhi Medical College ◽

Research Institute Hospital

Background: Appendicitis is the most common abdominal emergency worldwide. Lifetime risk of acute appendicitis is 8.6% and 6.7% for man and women respectively. Clinical examination is helpful in diagnosis of acute appendicitis in only 70-87% of the cases. To compare Tzanaki and Alvarado scoring system in diagnosing acute appendicitis.Methods: This was a prospective, comparative, cross-sectional study, which was conducted at the Mahatma Gandhi Medical College and Research Institute Hospital. Patients with acute appendicitis were included in the study. Relevant history, examination and laboratory investigations done. Patients were scored according to both Alvarado scoring system and Tzanakis scoring, and both were documented in the proforma. Sensitivity, specificity, positive predictive value, negative predictive value were assessed and compared for both scoring systems.Results: 70 patients were included in this study. 54.3% of patients have Tzanakis score more than 8. 35.7% of patients have Alvarado score more than 7. 82.9% of patients had evidence of appendicitis in histopathological examination. Tzanakis score: sensitivity– 65.52%, specificity- 100%, PPV– 100%, NPV– 37.50%, accuracy– 71.43%. Alvarado score: sensitivity– 36.21%, specificity– 66.67%, PPV- 84%, NPV– 17.78%, accuracy– 41.43%.Conclusions: Tzanakis scoring system is an effective scoring system in diagnosing acute appendicitis.

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A Comparison between the Diagnostic Accuracy of Alvarado and Tzanaki Scoring Systems in Acute Appendicitis

10.53350/pjmhs2115123175 ◽

2021 ◽

Vol 15 (12) ◽

pp. 3175-3177

Author(s):

Anum Iftikhar ◽

Muhammad Arsalan ◽

Sheeza Azaz ◽

S H Waqar ◽

Sajid Ali Shah ◽

...

Keyword(s):

Acute Appendicitis ◽

Positive Predictive Value ◽

Diagnostic Accuracy ◽

Negative Predictive Value ◽

Predictive Value ◽

Gold Standard ◽

Scoring Systems ◽

Negative Appendectomy ◽

Alvarado Score ◽

Cross Sectional

Aim: To find out how accurate the Alvarado and Tzanaki scoring systems are in diagnosing acute appendicitis taking histopathology as gold standard. Methods: A cross-sectional prospective study was conducted from August 2019 to July 2020 at Department of General Surgery, Pakistan Institute of Medical Sciences Islamabad. Sixty patients were included, all of whom had appendectomies after a clinical diagnosis of acute appendicitis. Samples were submitted for histopathology, which was used as the gold standard for the definitive diagnosis of acute appendicitis. The specificity, sensitivity, positive predictive value (PPV), negative predictive value (NPV), diagnostic accuracy and negative appendectomy rate of Alvarado and Tzanaki scoring systems was calculated using SPSS version 23. Results: The sensitivity, specificity, positive predictive value, negative predictive value and diagnostic accuracy of Alvarado score at optimal cut-off threshold of ≥7.0, were calculated as 74%, 55%, 90%, 27% and 71.66% respectively. The cut-off threshold point of Tzanaki score was set at more than 8, which yielded a 94.11% sensitivity and an 88.88% specificity. The positive predictive value was 99.95% and the negative predictive value was 72.72%. The Alvarado and Tzanaki scoring systems had negative appendectomy rates of 9.5% and 2.04%, respectively. Conclusion: The Tzanaki scoring system has a better diagnostic accuracy for acute appendicitis as compared to the Alvarado score. Keywords: Acute appendicitis, Alvarado score, Tzanaki score

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ROLE OF ULTRASONOGRAPHY FOR EVALUATION OF ACUTE APPENDICITIS: A UNAMID EXPERIENCE

Pakistan Armed Forces Medical Journal ◽

10.51253/pafmj.v71isuppl-1.6214 ◽

2021 ◽

Vol 71 (Suppl-1) ◽

pp. S255-60

Author(s):

Muhammad Tahsin Hashmi ◽

Irum Taqi ◽

Amberin Taqi ◽

Hassan Junaid Sarwar

Keyword(s):

Acute Appendicitis ◽

Positive Predictive Value ◽

Predictive Value ◽

Cross Sectional Study ◽

Point Scale ◽

Field Hospital ◽

Cross Sectional ◽

Lower Quadrant ◽

Persistent Symptoms ◽

Operative Findings

Objective: To evaluate the accuracy of ultrasound findings as compared to operative findings and positive predictive value of ultrasonography in the diagnosis of acute appendicitis. Study Design: Cross sectional study. Place and Duration of Study: Pak Field Hospital – 7 (Level III) United Nations African Union Mission in Darfur (UNAMID) Darfur, Sudan, from Mar 2015 to Mar 2016. Methodology: All patients presenting with clinically suspected acute appendicitis (Alvarado’s score >4) were referred for right lower quadrant sonography. Three point scale was used to grade sonographic findings ranging from grade 1 to grade 3. Fifty One patients with persistent symptoms and/or positive sonographic findings were operated. Operative findings were also graded on a 3 point scale. Subsequently, sonographic and operative findings were compared. Surgical findings were considered gold standard to assess diagnostic accuracy of sonography. Results: Out of 51 patients 46 (90.2%) were males and 5 (9.8%) were females. Mean age of the patients was 32.3 ± 7.3 years. Among the study subjects, 15 (29.4%) patients were from Nigeria followed by 12 (23.5%) from Pakistan, 7 (13.7%) from Egypt and 17 (33.5%) from other countries.The sonographic findings were detected positive for acute appendicitis in 40 (78.4%) and negative in 11 (21.6%) out of 51. All Fifty-one patients underwent surgery. The surgical findings were positive for appendicitis in 43 patients (84.3%). Four patients with negative sonographic findings did have acute appendicitis according to surgical findings. The positive predictive value was 90.9%. There was good agreement between sonographicfindings and surgical findings..........

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A study to compare RIPASA (Raja Isteri Pengiran Anak Saleha Appendicitis) and Alvarado scores in diagnosing acute appendicitis in Indian population

International Surgery Journal ◽

10.18203/2349-2902.isj20181591 ◽

2018 ◽

Vol 5 (5) ◽

pp. 1826

Author(s):

Dijo S. Joseph ◽

Alfie J. Kavalakat ◽

John M. Mandumpala ◽

Suresh V. Mayyattil

Keyword(s):

Acute Appendicitis ◽

Predictive Value ◽

Scoring System ◽

Iliac Fossa ◽

Asian Population ◽

Scoring Systems ◽

Alvarado Score ◽

Cross Sectional ◽

Study Results ◽

Ripasa Score

Background: Acute appendicitis is one of the most common surgical emergencies. Various clinical scoring systems have been used for early diagnosis of acute appendicitis, of which Alvarado score is the most popular but it is found to be less accurate when applied to Asian population compared to RIPASA score. Radiological modalities such as computed tomography (CT) imaging may aid in making a definite diagnosis but will inflate the cost of treatment. This study aims to compare RIPASA and Alvarado scoring system in the diagnosis of acute appendicitis in our population.Methods: It was a comparative cross-sectional study done in 100 patients. RIPASA and Alvarado scores were applied to each patient. Our inclusion criteria were patients presenting with Right iliac fossa pain who subsequently underwent Appendicectomy in the same admission. Exclusion criteria included patients admitted under other specialties, those who underwent previous appendicectomy, elective appendicectomy and those not willing for the study. Results: The sensitivity and specificity of RIPASA score was 95.12% and 66.67% and that of ALVARADO score was 64.63% and 77.78%. The positive predictive value (PPV) and negative predictive value (NPV) of RIPASA score was 92.86% and 75% and that of Alvarado score was 92.98% and 32.5%. The diagnostic accuracy of Alvarado and RIPASA scores were 67.0% and 90.0% respectively.Conclusions: RIPASA scoring system is more accurate and specific scoring system for our population than Alvarado in diagnosing acute appendicitis.

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VALIDITY OF ALVARADO SCORING SYSTEM IN DIAGNOSIS OF ACUTE APPENDICITIS

Journal of Saidu Medical College, Swat ◽

10.52206/jsmc.2015.5.2.663-666 ◽

1969 ◽

Vol 5 (2) ◽

pp. 663-666

Author(s):

ASGHAR ALI ◽

ABDUR RAHMAN ◽

FAZAL RAHIM

Keyword(s):

Acute Appendicitis ◽

Scoring System ◽

Iliac Fossa ◽

Cross Sectional Study ◽

Alvarado Score ◽

Cross Sectional ◽

Female Ratio ◽

Suspected Appendicitis ◽

Surgical Ward ◽

Male To Female

BACKGROUND: The first appendectomy was performed by Claudius Amyand in 1736 when he wasoperating on a boy for hernia and found appendix lying in hernial sac. Reginald Fitz introduced the wordappendicitis in 1886 and before that it was called typhlitis or perityphlitis.Frederick Treves performedthe lstappendicle surgery in England for the new disease ‘appendicitis’ in 1887.OBJECTIVE: To study the accuracy of modified Alvarado scorning system in diagnosis of acuteappendicitis.MATERIAL & METHODS: This descriptive cross sectional study was conducted at DHQ HospitalTimergara Dir lower from January 2015 to July 2015 to find out the accuracy of Alvarado Scoringsystem in the diagnoses of acute appendicitis. A total of 50 patients admitted in surgical ward from OPDand Casualty with suspected appendicitis were included in the study. Patients less than 7 years andpatients with mass right iliac fossa were excluded. Every patient was evaluated with modified Alvaradoscoring system on a standard Proforma. Patients with Alvarado score of > 6 underwent appendectomy.The removed appendices were sent for histopathology to confirm or otherwise the provisional diagnosisof acute appendicitis and hence the accuracy of Alvarado scoring system.RESULTS: Out of 50 patients, 20 were male &30 were female with a male to female ratio of 1:1.5. Themean age of the patients was 19.7 ± 9.6years. The mean Alvarado score was 7.92 ± 1.383. TheHistopathology reports of the specimens of 37 patients were confirmative of acute appendicitis whereasthe rest of the (13 patients) removed appendices were reported normal by histopathalogist. So thesensitivity is 74%.CONCLUSION: Our study shows that Alvarado scoring system is a simple and quick tool in theevaluation and management of suspected cases of acute appendicitis. Its accuracy increases if used inpatients above 14 years of age.KEYWORD: Alvarado scoring system, Appendicitis, Accuracy.

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“A COMPARATIVE STUDY OF RIPASA SCORE AND ALVARADO SCORE IN THE DIAGNOSIS OF ACUTE APPENDICITIS”

10.36106/ijar/3200856 ◽

2021 ◽

pp. 25-28

Author(s):

M. Vijaya Kumar ◽

Manasa Manasa

Keyword(s):

Acute Appendicitis ◽

Diagnostic Accuracy ◽

Predictive Value ◽

Scoring System ◽

Local Population ◽

Scoring Systems ◽

Signs And Symptoms ◽

Alvarado Score ◽

Predictive Values ◽

Ripasa Score

Acute appendicitis is the most common condition encountered in the Emergency department .Alvarado and Modied Alvarado scores are the most commonly used scoring system used for diagnosing acute appendicitis.,but its performance has been found to be poor in certain population . Hence our aim was to compare the diagnostic accuracy of RIPASA and ALVARADO Scoring system and study and compare sensitivity, specicity and predictive values of these scoring systems. The study was conducted in Government district hospital Nandyal . We enrolled 176 patients who presented with RIF pain . Both RIPASA and ALVARADO were applied to them. Final diagnosis was conrmed either by CT scan, intra operative nding or post operative HPE report. Sensitivity,specicity, positive predictive value, negative predictive value, diagnostic accuracy was calculated both for RIPASA and ALVARADO. It was found that sensitivity and specicity of the RIPASA score in our study are 98.7% and 83.3%, respectively. PPV and NPV were 98.1% and 88.2% and sensitivity and specicity of the Alvardo score in our study are 94.3% and 83.3%, respectively. PPV and NPV were 98% and 62.5%.Diagnostic accuracy of RIPASA score and Alvarado score are 97% and 93% respectively. RIPASA is a more specic and accurate scoring system in our local population when compared to ALVARADO . It reduces the number of missed appendicitis cases and also convincingly lters out the group of patients that would need a CT scan for diagnosis (score 5-7.5 ) BACKGROUND: Acute appendicitis is one of the most commonly dealt surgical emergencies, with a lifetime prevalence rate of approximately 1 one in seven. The incidence is 1.5–1.9 per 1,000 in the male and female population, and is approximately 1.4 times greater in men than in women. Despite being a common problem, it remains a difcult diagnosis to establish, particularly among the young, the elderly and females of reproductive age, where a host of other genitourinary and gynaecological inammatory conditions can present with signs and symptoms that are 2 similar to those of acute appendicitis. A delay in performing an appendectomy in order to improve its diagnostic accuracy increases the risk of appendicular perforation and peritonitis, which in turn increases morbidity and mortality. A variable combination of clinical signs and symptoms has been used together with laboratory ndings in several scoring systems proposed for suggesting the probability of Acute Appendicitis and the possible subsequent management pathway. The Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) and ALVARADO score are new diagnostic scoring systems developed for the diagnosis of Acute Appendicitis and has been shown to have signicantly higher sensitivity, specicity and diagnostic accuracy. AIMS AND OBJECTIVES PRIMARY OBJECT 1. To compare RIPASA Scoring system and ALVARADO Scoring system in terms of diagnostic accuracy in Acute Appendicitis. 2. To study and compare sensitivity, specicity and predictive values of above scoring systems. SECONDARY OBJECT 1. To study the rate of negative appendicectomy based on above scoring systems. CONCLUSION: The RIPASA score is a simple scoring system with high sensitivity and specicity for the diagnosis of acute appendicitis. The 14 clinical parameters are all present in a good clinical history and examination and can be easily and quickly applied. Therefore, a decision on the management can be made early. Although the RIPASA score was developed for the local population of Brunei, we believe that it should be applicable to other regions. The RIPASA score presents greater Diagnostic accuracy and Sensitivity and equal specicity as a diagnostic test compared to the Alvarado score and is helpful in making appropriate therapeutic decisions. In hospitals like ours, the diagnosis of AA relies greatly on the clinical evaluation performed by surgeons. An adequate clinical scoring system would avoid diagnostic errors, maintaining a satisfactory low rate of negative appendectomies by adequate patient stratication, while limiting patient exposure to ionizing radiation, since 21 there is an increased risk of developing cancer with computed tomography, particularly for the paediatric age group.

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A study to assess the role of raised total leucocyte count in diagnosis of acute appendicitis

International Journal of Advances in Medicine ◽

10.18203/2349-3933.ijam20204068 ◽

2020 ◽

Vol 7 (10) ◽

pp. 1541

Author(s):

Rajesh Kumar ◽

Renu Chauhan

Keyword(s):

Acute Appendicitis ◽

Predictive Value ◽

Leucocyte Count ◽

Histopathological Examination ◽

Perforated Appendicitis ◽

Cross Sectional Study ◽

Total Leucocyte Count ◽

Cross Sectional ◽

Gandhi Medical College ◽

Low Sensitivity

Introduction: Total Leucocyte Count (TLC) is an easily available and commonly performed investigation and studies have reported various degrees of leucocytosis in patients with acute appendicitis. This study was performed with the aim to assess the diagnostic validity of raised TLC count in acute appendicitis.Methods: This was a cross sectional study conducted from 2013 to 2015, in the Department of General Surgery, Indira Gandhi Medical College, Shimla. A clinical diagnosis of acute appendicitis was made based on detailed history taking, clinical examination, and laboratory investigations including TLC count. 50 patients with acute appendicitis were enrolled in the study by convenience sampling, after taking a written, informed consent. Appendicectomy specimen were sent for histopathological examination (HPE).Results: The mean age of the patients was 26.48 ± 12.28 years. 29 (58%) patients were male, and 21 (42%) were female. The negative appendicectomy rate in the present study was 14%. 7 (14%) were normal appendices, 31 (62%) inflamed appendices, 4 (8%) perforated appendices, and 8 (16%) gangrenous appendices as per HPE report. In our study, there were 12 (24%) cases of complicated appendicitis i.e., 8 (16%) cases of gangrenous appendicitis and 4 (8%) cases of perforated appendicitis). TLC had a sensitivity 76.74%, specificity 51.14%, positive predictive value 91.66%, and negative predictive value 28.57%.Conclusion: In our study, TLC was found to have low sensitivity and specificity for acute appendicitis. Hence, used alone, TLC may not be diagnostic of acute appendicitis. However, used in conjunction with other laboratory parameters, it will lead to improvement of diagnostic accuracy.

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Diagnostic Performance and Reliability of the Standardized Computed Tomography Reporting System for Acute Appendicitis: Experience in a Tertiary Care Academic Center

Journal of the Medical Association of Thailand ◽

10.35755/jmedassocthai.2021.07.12434 ◽

2021 ◽

Vol 104 (7) ◽

pp. 1102-1108

Keyword(s):

Computed Tomography ◽

Acute Appendicitis ◽

Diagnostic Accuracy ◽

Predictive Value ◽

Diagnostic Performance ◽

Interobserver Agreement ◽

Reporting System ◽

Lower Quadrant ◽

Suspected Appendicitis ◽

Diagnostic Certainty

Background: Computed tomography (CT) is generally accepted as a modality of choice for imaging workup in patients with suspected appendicitis. A standardized CT reporting system, CT certainty score, has been proposed to improve diagnostic accuracy and to reduce ambiguous CT reports. Objective: To assess the diagnostic performance and the reliability of the standardized CT reporting system for acute appendicitis in Thai adults. Materials and Methods: The present study was a retrospective data review of 421 adult patients who had CT scans of the appendix between January 2016 and December 2017. The clinical and imaging data were extracted and analyzed. The pathological result was used as a standard of reference. The diagnostic performance and interobserver agreement of the standardized CT reporting system were estimated. Results: One hundred sixty-three patients, with a mean age of 41.7 years, had clinical diagnoses of acute appendicitis. Using standardized CT report, radiologists were highly accurate at diagnosing appendicitis [area under curve (AUC) 0.988 (95% CI 0.98 to 1.00); p<0.001]. The estimated sensitivity, specificity, positive predictive value, negative predictive value, and accuracy were 95.1% (95% CI 90.6 to 97.9), 95.7% (95% CI 92.5 to 97.9), 93.4% (95% CI 88.7 to 96.2), 96.9% (95% CI 93.0 to 97.2), 95.5% (95% CI 93.0 to 97.3), respectively. The interobserver agreement was greater than 80% for all binary objective findings and more than 90% agreement on the presence or absence of greater-than-3-mm wall thickness, appendicolith, periappendiceal air, and right lower quadrant fluid collection. The use of CT certainty score had interobserver agreement of 78% (κ=0.69; 95% CI 0.62 to 0.77). Conclusion: Using a standardized CT reporting system yielded a high diagnostic accuracy and high reproducibility of supportive CT findings for appendicitis in at-risk patients. The standardized CT reporting system can improve diagnostic certainty, accuracy, and guide patient management. Keywords: Appendicitis; Certainty score; Computed tomography; Standardized reporting system

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Cross-Cultural Adaptation and Quantitative Evaluation of Dysfunctional Voiding and Incontinence Scoring System in Pediatric Serbian Population

Medicina ◽

10.3390/medicina55040100 ◽

2019 ◽

Vol 55 (4) ◽

pp. 100

Author(s):

Dragana Cirovic ◽

Ivana Petronic ◽

Jasna Stojkovic ◽

Ivan Soldatovic ◽

Polina Pavicevic ◽

...

Keyword(s):

Scoring System ◽

Pediatric Population ◽

Scoring Systems ◽

Cross Sectional Study ◽

Repeated Measurements ◽

Receiver Operating Curve ◽

Dysfunctional Voiding ◽

Cross Sectional ◽

Significant Difference ◽

Test Retest Reliability

Background and objective: Dysfunctional voiding (DV) presents relatively frequent problem in pediatric urologist practice. The necessity for implementation of DV evaluation in the pediatric population is of particular importance, since there is no clear consensus on the clinical assessment of such condition. The aims of our study were to evaluate the test/retest reliability and reproducibility of dysfunctional voiding and incontinence scoring system: Serbian version (DVISSSR) in patients with voiding and incontinence dysfunctions without structural deformities, and to estimate cut-off value for DVISSSR. Methods: The cross-sectional study included 57 children with voiding and incontinence dysfunctions and 30 healthy pediatric controls. For the evaluation of voiding and incontinence dysfunction we used DVISS. The forward–backward method was applied for translation of the DVISS questionnaire from English into Serbian language. Reproducibility was analyzed by Interclass Correlation Coefficient (ICC). Sensitivity and specificity of DVISSSR scores was done by receiver operating curve (ROC) curve. Results: There was a significant difference in DVISSSR score between patients and controls (p < 0.001). For reliability and reproducibility of the questionnaire, there was no significant difference between repeated measurements (p = 0.141), and strong reliability (ICC = 0.957; p < 0.001). Conclusion: We have demonstrated successful translation and validation of the DVISSSR score. Moreover, a reliable scoring system of children with voiding dysfunctions should include evaluations of symptom scoring systems at the multicentric level.

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