The Role of Digital Rectal Examination for Diagnosis of Acute Appendicitis: A Systematic Review and Meta-Analysis

PloS One
Toshihiko TakadaShunichi Fukuhara

Abstract

Digital rectal examination (DRE) has been traditionally recommended to evaluate acute appendicitis, although several reports indicate its lack of utility for this diagnosis. No meta-analysis has examined DRE for diagnosis of acute appendicitis. To assess the role of DRE for diagnosis of acute appendicitis. Cochrane Library, PubMed, and SCOPUS from the earliest available date of indexing through November 23, 2014, with no language restrictions. Clinical studies assessing DRE as an index test for diagnosis of acute appendicitis. Two independent reviewers extracted study data and assessed the quality, using the Quality Assessment of Diagnostic Accuracy Studies 2 tool. Bivariate random-effects models were used for the pooled sensitivity, specificity, positive likelihood ratio, negative likelihood ratio, and diagnostic odds ratio (DOR) as point estimates with 95% confidence intervals (CI). The main outcome measure was the diagnostic performance of DRE for diagnosis of acute appendicitis. We identified 19 studies with a total of 7511 patients. The pooled sensitivity and specificity were 0.49 (95% CI 0.42-0.56) and 0.61 (95% CI 0.53-0.67), respectively. The positive and negative likelihood ratios were 1.24 (95% CI 0.97-1.58) and 0.85 ...Continue Reading

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Citations

Jul 22, 2018·Emergency Medicine Journal : EMJ·Mansoor Khan
Jul 22, 2018·Emergency Medicine Journal : EMJ·Osama Aa Elhardello, John MacFie
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Feb 4, 2021·Deutsches Ärzteblatt International·Patrick TéouleChristoph Reissfelder
Jan 6, 2021·The American Journal of Emergency Medicine·Toshihiko TakadaShunichi Fukuhara

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