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Acute abdominal pain in children
J A Dickson1, A Jones, S Telfer
1Children's Hospital, Sheffield, England.
Insights
This study found that acute appendicitis and non-specific abdominal pain (NSAP) are the main causes of acute abdominal pain in children. A new computer-aided diagnosis database for children showed improved specificity compared to clinicians.
Area of Science:
- Pediatric Gastroenterology
- Medical Informatics
Background:
- The disease spectrum and clinical presentation of acute abdominal pain in children differ significantly from adults.
- Existing computer-aided diagnosis databases may not be optimal for pediatric populations due to age-related differences.
Purpose of the Study:
- To investigate the disease spectrum and clinical presentation of acute abdominal pain in 1080 children across multiple international hospitals.
- To evaluate the effectiveness of a new computer-aided diagnosis database specifically designed for children.
Main Methods:
- Data collection from 1080 pediatric patients with acute abdominal pain from hospitals in England, France, Norway, Denmark, and the Netherlands.
- Creation and testing of a new database using only pediatric data for computer-aided diagnosis.
- Comparison of the new database's diagnostic sensitivity and specificity against that of inexperienced clinicians.
Main Results:
- Acute appendicitis and non-specific abdominal pain (NSAP) account for over 90% of pediatric acute abdominal pain cases.
- The new pediatric database demonstrated a sensitivity for appendicitis (79.6%) comparable to clinicians (77.3%).
- The computer-aided diagnosis system exhibited higher specificity (over 70%) than clinicians (52.7%).
Conclusions:
- The disease spectrum and presentation of acute abdominal pain in children necessitate age-specific diagnostic approaches.
- A dedicated pediatric database improves computer-aided diagnosis for conditions like appendicitis in children.
- Disciplined data collection is crucial for developing effective diagnostic tools in pediatric medicine.
Abstract:
This preliminary communication describes the initial results of a further special study investigating the disease spectrum and clinical presentation in a total of 1080 children admitted to hospital with acute abdominal pain (677 from the Children's Hospital, Sheffield, England, and the remaining 403 from hospitals in Paris, Oslo, Copenhagen, and Deventer). The disease spectrum in children differs radically from that in adults, well over 90% of cases being due to either acute appendicitis or non-specific abdominal pain (NSAP). The clinical presentation of both appendicitis and NSAP was found to differ from that in older age groups. These findings imply clearly that the use of the existing OMGE database for computer-aided diagnosis--using data drawn from cases of all ages--may not be optimal in children. A fresh database (using only children's data) was therefore created and tested. Its sensitivity for appendicitis was equivalent to that of inexperienced clinicians (79.6% versus 77.3%). The computer's specificity (over 70%) was higher than that of clinicians (52.7%). The findings also re-emphasise the value of disciplined data collection, and the implications for teaching are discussed.