Usefulness and limitations of modified Alvarado scoring system in diagnosis of acute appendicitis

ABSTRACT

To find out the validity of modified Alvarado scoring system in diagnosis of acute appendicitis in comparison with clinical diagnosis. A randomized controlled trial comparing clinical diagnosis with modified Alvarado scoring in 100 patients of acute appendicitis was under taken. The study was conducted from December 2004 to August 2005. Out of 100 patients, 50 patients were randomly evaluated with modified Alvarado scoring on a standard proforma provided with patients' history sheets. The other group of 50 patients was evaluated clinically. The gold standard was histopathology report on which the true positive or negative results were recorded. Mean age of the patients was 25.34 years with a male to female ratio of 1.21. The histopathology reports were positive in 47 [94%] patients operated on the basis of modified Alvarado scoring with false positive rate of 12% and a sensitivity of 88%. In the controlled group of patients operated on the basis of clinical diagnosis the histopathology reports were positive in 36 [72%] cases with a false positive rate of 24%. The sensitivity of clinically evaluated group was 76%. The modified Alvarado scoring system is an effective scoring system. It is simple, easy to apply, and reproducible. It should be used routinely in diagnosis of acute appendicitis