Added Value of Structured Reporting for US of the Pediatric Appendix: Additional CT Examinations and Negative Appendectomy

Abstract

Purpose This study aimed to determine the incremental value of using a structured report (SR) for US examinations of the pediatric appendix. Materials and Methods Between January 2009 and June 2016, 1150 pediatric patients with suspected appendicitis who underwent US examinations of the appendix were included retrospectively. In November 2012, we developed a five-point scale SR for appendix US examinations. The patients were divided into two groups according to the form of the US report: free-text or SR. The primary clinical outcomes were compared between the two groups, including the rate of CT imaging following US examinations, the negative appendectomy rate (NAR), and the appendiceal perforation rate (PR). Results In total, 550 patients were included in the free-text group and 600 patients in the SR group. The rate of additional CT examinations decreased by 5.3% in the SR group (8.2%, p = 0.003), and the NAR decreased by 8.4% in the SR group (7.8%, p = 0.028). There was no statistical difference in the appendiceal PR (37.6% vs. 48.0%, p = 0.078). Conclusion The use of an SR to evaluate US examinations for suspected pediatric appendicitis results in lower CT use and fewer negative appendectomies without an increase in appendiceal PR.

Structured Reporting for Pediatric Appendiceal US: Can It Reduce CT Utilization Rate and Decrease the Negative Appendectomy Rate?

“…In this issue of JKSR, Choi et al ( 5 ) retrospectively assessed the value of structured reporting for the US diagnosis of pediatric appendicitis. The study included 1150 pediatric patients (free-text group: 550; structured reporting group: 600) with suspected appendicitis who underwent US examination of the appendix between January 2009 and June 2016.…”

“…In summary, Choi et al ( 5 ) provided more evidence of the benefits of structured reporting in the diagnosis of acute appendicitis. The structured reporting of US of the appendix can improve the accuracy of the diagnosis of pediatric appendicitis, reduce the CT utilization rate, and decrease the negative appendectomy rate.…”