Comparing the Accuracy of Ohmann and Alvarado Scor-ing Systems in Detection of Acute Appendicitis; a Cross-Sectional Study

Alvarado Scoring System (ASS) and Ohmann Scoring System (OSS) are two scoring systems for di-agnosing acute appendicitis (AA). This study was designed to compare the diagnostic accuracy of the two men-tioned scores in detection of acute abdominal cases at risk for AA.

In this prospective cross-sectionalstudy, patients admitted to the emergency departments of two academic hospitals in Qom, Iran, with right lowerquadrant (RLQ) abdominal pain suspected to AA were evaluated. All cases were scored using ASS and OSS, andscreening performance characteristics of the two scores were calculated and reported considering the patho-logic findings as a gold standard.

174 patients with a preliminary AA diagnosis and the mean age of38.1 ± 10.63 years (11- 73) were included in this study (62.07% male). At the optimal cutoff point of≥7 for theASS, the sensitivity and the specificity were 46.43% (95% CI: 37.97%-55.07%), 97.05% (95% CI: 84.67%-92.93%),respectively. At the optimal cutoff point of≥11 for the OSS, the sensitivity and the specificity were 74.29% (95%CI: 66.22%-81.29%), and 55.88% (95% CI: 37.89% - 72.82%), respectively.

Based on the finding ofthis study, the ASS≥7 was more accurate than the OSS≥11 for detection of AA. But it should be considered thatthe overall accuracy of Alvarado and Ohmann scores in this regard were fair (0.83) and poor (0.67), respectively.