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Related Concept Videos

Appendicitis-I: Introduction01:22

Appendicitis-I: Introduction

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The appendix, a small, narrow, blind tube extending from the inferior part of the cecum, is widely regarded as a vestigial organ, having lost much of its original function through evolution. Despite its diminished role, the appendix can become inflamed, a condition known as appendicitis.
Etiology: Appendicitis can arise from various causes, primarily rooted in the obstruction of the appendix lumen. Factors contributing to this obstruction include fecal accumulation, lymphoid hyperplasia and, in...
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Appendicitis-II: Diagnostic Studies and Management01:29

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Diagnosing and managing appendicitis requires a structured and comprehensive approach that spans from initial assessment to postoperative care. Here is an overview of the process:
Diagnosing Appendicitis
It requires a multifaceted approach, starting with a detailed physical examination to pinpoint the location and nature of the pain and identify any associated symptoms. Laboratory tests play a crucial role. A complete Blood Count (CBC) typically reveals leukocytosis (an increased number of...
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Variability: Analysis01:11

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Measures of variability are statistical metrics that reveal the dispersion pattern within a dataset. They are pivotal in biostatistics, providing insights into the heterogeneity within health and biological data. Variability signifies the degree to which data points diverge from one another, helping researchers understand the potential range of values and associated uncertainty within the data.
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Random Variables01:09

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A random variable is a single numerical value that indicates the outcome of a procedure. The concept of random variables is fundamental to the probability theory and was introduced by a Russian mathematician, Pafnuty Chebyshev, in the mid-nineteenth century.
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An equation with two variables, typically written in the form y = f(x) or Ax + By = C, describes a relationship between quantities represented by x and y. Each solution to such an equation is an ordered pair (x, y) that satisfies the equation when substituted. These pairs can be represented graphically to understand the variables' relationship visually.A common technique for constructing the graph of a two-variable equation is to create a value table. Begin by choosing several values for the...
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Fluorescence and phosphorescence are essential phenomena in fields like analytical chemistry, biological imaging, and materials science, where they detect molecular properties and visualize cellular structures. Understanding the variables that influence these luminescent behaviors is crucial for maximizing accuracy and efficiency in their applications. These variables can broadly be grouped into chemical structure, solvent properties, and external conditions, each playing a distinct role in...
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Laparoscopy-endoscopy Cooperative Surgery for the Treatment of Gastric Gastrointestinal Stromal Tumors
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Interobserver variability in the classification of appendicitis during laparoscopy.

A L van den Boom1, E M L de Wijkerslooth1, K A L Mauff2

  • 1Department of Surgery, Erasmus MC - University Medical Centre, Rotterdam, The Netherlands.

The British Journal of Surgery
|April 18, 2018
PubMed
Summary
This summary is machine-generated.

Surgeons show significant variability in classifying appendicitis during surgery, impacting antibiotic treatment decisions. Standardized criteria may improve agreement for better patient care.

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Area of Science:

  • Surgical diagnostics
  • Medical imaging analysis
  • Clinical decision-making

Background:

  • Intraoperative appendicitis classification guides postoperative management.
  • Complex appendicitis (gangrenous, perforated, abscess) requires prolonged antibiotics, unlike simple appendicitis.
  • Differentiating between simple and complex appendicitis intraoperatively is challenging.

Purpose of the Study:

  • To assess interobserver variability in laparoscopic appendicitis classification.
  • To evaluate agreement on postoperative antibiotic prescription based on intraoperative findings.

Main Methods:

  • Surgeons and residents classified appendicitis severity from laparoscopic video recordings.
  • Assessors categorized appendix appearance and decided on postoperative antibiotics.
  • Inter-rater reliability was measured using Fleiss' κ score and S* statistic.

Main Results:

  • Minimal interobserver agreement was found for appendicitis classification (κ=0.398) and antibiotic decisions (κ=0.378).
  • Agreement improved slightly when using established published criteria (κ=0.552).
  • 80 assessors reviewed videos from 20 patients.

Conclusions:

  • Considerable variability exists in the intraoperative classification of appendicitis.
  • This variability extends to decisions regarding postoperative antibiotic treatment.
  • Standardized criteria may enhance diagnostic and treatment consistency.