Riff At Arbab, Muhammad Iqbal Khan, Maria Mehmood, Mehnaz Mir Marri, Jamil Ahmed Khan.
Diagnostic accuracy of modified Alvarado score in the prediction of acute appendicitis.
Pak J Surg Jan ;29(4):272-7.

Objective: To evaluate diagnostic accuracy of the Modifi ed Alvarado Scoring to predict acute appendicitis among patients admitt ed in a tertiary care hospital. Design: Cross sectional study. Sett ing and Duration: Surgical Unit-I of the Sandeman Provincial Teaching Hospital Quett a from 1st July 2012 to 31st December 2012. Methodology: A sample of 160 patients was collected by non- probability purposive sampling technique. Patients presenting with right iliac fossa Pain admitt ed in emergency department of a tertiary care hospital were clinically evaluated for need of surgery. Th ey were assessed by a senior consultant of the surgical department. Modifi ed Alvarado Score was recorded but its result was not disclosed to eff ect the decision of Surgery. Aft er appendicectomy the appendix was sent for histopathology which was taken as gold standard. Th e results of histopathology and Alvarado Scoring were compared to assess the diagnostic accuracy of the Modifi ed Alvarado Score. Th e data was compiled and analyzed by SPSS. 16 Results: Th e calculated sensitivity and specifi city of Modifi ed Alvarado Scoring with cut-off value of 7 in our study was 53.8% and 50% respectively. Th e positive predicted value and negative predictive value of Modifi ed Alvarado Scoring with cut-off value of 7 was 97.6% and 2.7% respectively. Th e percentage of false positivity (FP) according to the formula was 50% and that of false negativity (FN) was 46.16%. Hence the accuracy of Modifi ed Alvarado Scoring according to the formula was 53.7%. Conclusion: Modifi ed Alvarado Scoring is less reliable in the diagnosis of Acute Appendicitis.

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