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An Approach to Model Right Iliac Fossa Pain Using Pain-Only-Parameters for Screening Acute Appendicitis

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Abstract

Acute appendicitis (AA) is one of the commonest of multiple possible pathologies at the backdrop of Right Iliac Fossa (RIF) pain. RIFis the most common acute surgical condition of the abdomen. Even though AA is a recognized disease entity since decades, its diagnosis still lacks clinical confidence and mandates laboratory tests. Given the issue, this paper proposes a mathematical model using Pain-Only-Parameters (POP) obtained from available literature to screen AA. Weights have been assigned for each POP to create a training data matrix (N = 51) and used to calculate the cumulative effect or weighted sum, which is termed as the Pain Confidence Score (PCS). Based on PCS, a group of real-world patients (N = 40; AA and NA = 20 each) are classified as cases of AA or non-appendicitis (NA) with satisfactory results (sensitivity 85%, specificity 75%, precision 77%, and accuracy 80%). Most rural health centers (RHC) in developing nations lack specialist services and related infrastructure. Hence, such a tool could be useful in RHC to assist general physicians in screening AA and their timely referral to higher centers.

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Abbreviations

AA:

Acute Appendicitis

CT:

Computed Tomography

CRP:

C-reactive protein

NA:

Non Appendicitis

PCS:

Pain Confidence Score

POP:

Pain-only-parameters

RIF:

Right iliac fossa

RHC:

Rural health centers

SPSS:

Statistical Package for the Social Sciences

USG:

Ultrasonography

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Authors and Affiliations

  1. School of Computer Studies, National Institute of Science and Technology, Berhampur, 761008, Orissa, India

    Subhagata Chattopadhyay

  2. School of Computer Science and Engineering, The University of New South Wales, Sydney, NSW, 2052, Australia

    Fethi Rabhi

  3. Department of Electronic and Communication Engineering, Ngee Ann Polytechnic, Clementi, 599489, Singapore

    U. Rajendra Acharya

  4. Department of Biomedical Engineering, Manipal Institute of Technology, Manipal University, Manipal, 576104, Karnataka, India

    Rohan Joshi & Rudhram Gajendran

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  1. Subhagata Chattopadhyay
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  2. Fethi Rabhi
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  5. Rudhram Gajendran
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Correspondence to U. Rajendra Acharya.

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Chattopadhyay, S., Rabhi, F., Acharya, U.R. et al. An Approach to Model Right Iliac Fossa Pain Using Pain-Only-Parameters for Screening Acute Appendicitis. J Med Syst 36, 1491–1502 (2012). https://doi.org/10.1007/s10916-010-9610-0

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