CONTEXT: Misdiagnosis of presumed @entity698 is an adverse outcome that leads to unnecessary surgery. Computed tomography, ultrasonography, and laparoscopy have been suggested for use in @entity1 with equivocal signs of @entity698 to decrease unnecessary surgery. OBJECTIVE: To determine if frequency of misdiagnosis preceding appendectomy has decreased with increased availability of computed tomography, ultrasonography, and laparoscopy. DESIGN, SETTING, AND @entity1 : Retrospective, population-based cohort study of data from a Washington State hospital discharge database for 85 790 residents assigned International Classification of Diseases, Ninth Revision procedure codes for appendectomy, and United States Census Bureau data for 1987-1998. MAIN OUTCOME MEASURE: Population-based age- and sex-standardized incidence of appendectomy with @entity697 (perforated or not) or with a normal appendix. RESULTS: Among 63 707 nonincidental appendectomy @entity1 , 84.5% had @entity698 (25.8% with perforation) and 15.5% had no associated diagnosis of @entity698 . After adjusting for age and sex, the population-based incidence of unnecessary appendectomy and of @entity698 with perforation did not change significantly over time. Among @entity1 of reproductive age, the population-based incidence of misdiagnosis increased 1% per year (P =.005). The incidence of misdiagnosis increased 8% yearly in @entity1 older than 65 years (P<.001) but did not change significantly in @entity1 younger than 5 years (P =.17). The proportion of @entity1 undergoing laparoscopic appendectomy who were misdiagnosed was significantly higher than that of open appendectomy @entity1 (19.6% vs 15.5%; P<.001). CONCLUSION: Contrary to expectation, the frequency of misdiagnosis leading to unnecessary appendectomy has not changed with the introduction of computed tomography, ultrasonography, and laparoscopy, nor has the frequency of perforation decreased. These data suggest that on a population level, diagnosis of @entity698 has not improved with the availability of advanced diagnostic testing.

Has misdiagnosis of XXXX decreased over time? A population-based analysis.

@entity1 :: ('9606', 'Species') :: ['women', 'children', 'patients', 'PATIENTS'] @entity697 :: ('MESH:D000208', 'Disease') :: ['acute appendicitis'] @entity698 :: ('MESH:D001064', 'Disease') :: ['appendicitis']
@entity698 :: (MESH:D001064,Disease) :: ['appendicitis']
