Computed Tomography and Ultrasonography To Detect Appendicitis
Authors: Teruhiko Terasawa, C. Craig Blackmore
Journal: Annals of Internal Medicine (2005)

Letters3 May 2005Computed Tomography and Ultrasonography To Detect AppendicitisTeruhiko Terasawa, MD and C. Craig Blackmore, MD, MPHTeruhiko Terasawa, MDFrom the National Hospital Organization and Nagoya Medical Center, Nagoya, Japan 460-0001, and Harborview Medical Center, Seattle, WA 98104.Search for more papers by this author and C. Craig Blackmore, MD, MPHFrom the National Hospital Organization and Nagoya Medical Center, Nagoya, Japan 460-0001, and Harborview Medical Center, Seattle, WA 98104.Search for more papers by this authorAuthor, Article, and Disclosure Informationhttps://doi.org/10.7326/0003-4819-142-9-200505030-00024 SectionsAboutFull TextPDF ToolsAdd to favoritesDownload CitationsTrack CitationsPermissions ShareFacebookTwitterLinkedInRedditEmail IN RESPONSE:We agree with Dr. Razzak that cost-effectiveness is critical to selection of appropriate imaging, as is local availability of imaging technologies. Furthermore, different imaging strategies may be appropriate in different subsets of patients. These areas would benefit from further investigation.We agree with Drs. Shiga, Wajima, and Inoue that summary ROC curves (1) and funnel plots may be useful in meta-analysis. We had performed similar analyses but did not include the results because of several concerns. Summary ROC curves may be affected by the assumptions used in curve calculation and are less useful at the bedside than likelihood ...References1. Moses LE, Shapiro D, Littenberg B. Combining independent studies of a diagnostic test into a summary ROC curve: data-analytic approaches and some additional considerations. Stat Med. 1993;12:1293-316. [PMID: 8210827] CrossrefMedlineGoogle Scholar2. Sterne JA, Egger M, Smith GD. Systematic reviews in health care: Investigating and dealing with publication and other biases in meta-analysis. BMJ. 2001;323:101-5. [PMID: 11451790] CrossrefMedlineGoogle Scholar3. Kosinski AS, Barnhart HX. A global sensitivity analysis of performance of a medical diagnostic test when verification bias is present. Stat Med. 2003;22:2711-21. [PMID: 12939781] CrossrefMedlineGoogle Scholar4. Whiting P, Rutjes AW, Reitsma JB, Bossuyt PM, Kleijnen J. The development of QUADAS: a tool for the quality assessment of studies of diagnostic accuracy included in systematic reviews. BMC Med Res Methodol. 2003;3:25. [PMID: 14606960] CrossrefMedlineGoogle Scholar Author, Article, and Disclosure InformationAuthors: Teruhiko Terasawa, MD; C. Craig Blackmore, MD, MPHAffiliations: From the National Hospital Organization and Nagoya Medical Center, Nagoya, Japan 460-0001, and Harborview Medical Center, Seattle, WA 98104.Disclosures: None disclosed. PreviousarticleNextarticle Advertisement FiguresReferencesRelatedDetailsSee AlsoSystematic Review: Computed Tomography and Ultrasonography To Detect Acute Appendicitis in Adults and Adolescents Teruhiko Terasawa , C. Craig Blackmore , Stephen Bent , and R. Jeffrey Kohlwes Computed Tomography and Ultrasonography To Detect Appendicitis Junaid A. Razzak Computed Tomography and Ultrasonography To Detect Appendicitis Toshiya Shiga , Zen'ichiro Wajima , and Tetsuo Inoue Computed Tomography and Ultrasonography To Detect Appendicitis Masashi Goto Metrics 3 May 2005Volume 142, Issue 9Page: 800KeywordsAppendicitisComputed axial tomographyConflicts of interestLikelihood ratioReceiver operating characteristic curveSpecificitySurgeryUltrasound imaging ePublished: 3 May 2005 Issue Published: 3 May 2005 Copyright & PermissionsCopyright © 2005 by American College of Physicians. All Rights Reserved.PDF downloadLoading ...