Machine-learning based prediction of appendicitis for patients presenting with acute abdominal pain at the emergency department.

Journal: World journal of emergency surgery : WJES
PMID:

Abstract

BACKGROUND: Acute abdominal pain (AAP) constitutes 5-10% of all emergency department (ED) visits, with appendicitis being a prevalent AAP etiology often necessitating surgical intervention. The variability in AAP symptoms and causes, combined with the challenge of identifying appendicitis, complicate timely intervention. To estimate the risk of appendicitis, scoring systems such as the Alvarado score have been developed. However, diagnostic errors and delays remain common. Although various machine learning (ML) models have been proposed to enhance appendicitis detection, none have been seamlessly integrated into the ED workflows for AAP or are specifically designed to diagnose appendicitis as early as possible within the clinical decision-making process. To mimic daily clinical practice, this proof-of-concept study aims to develop ML models that support decision-making using comprehensive clinical data up to key decision points in the ED workflow to detect appendicitis in patients presenting with AAP.

Authors

  • Anoeska Schipper
  • Peter Belgers
    Diagnostic Image Analysis Group, Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands.
  • Rory O'Connor
    a Academic Department of Rehabilitation Medicine , University of Leeds , Leeds , UK.
  • Kim Ellis Jie
    Emergency Department, Jeroen Bosch Hospital, 's Hertogenbosch, the Netherlands.
  • Robin Dooijes
    Emergency Department, Jeroen Bosch Hospital, 's Hertogenbosch, the Netherlands.
  • Joeran Sander Bosma
    Diagnostic Image Analysis Group, Department of Medical Imaging, Radboud University Medical Center, Nijmegen, the Netherlands.
  • Steef Kurstjens
    Laboratory for Clinical Chemistry and Hematology, Jeroen Bosch Hospital, 's-Hertogenbosch, The Netherlands.
  • Ron Kusters
    Laboratory of Clinical Chemistry and Hematology, Jeroen Bosch Hospital's, Hertogenbosch, the Netherlands.
  • Bram van Ginneken
    Diagnostic Image Analysis Group, Department of Radiology and Nuclear Medicine, Radboud University Medical Center, Nijmegen, The Netherlands; Fraunhofer Mevis, Bremen, Germany.
  • Matthieu Rutten
    From the Diagnostic Image Analysis Group, Radboud University Medical Center, Geert Groteplein 10, Nijmegen 6500 HB, the Netherlands (K.M., E.T.S., S.S., C.M.S., B.v.G.); Department of Radiology, Bernhoven Hospital, Uden, the Netherlands (H.S.); Department of Radiology, Jeroen Bosch Hospital, 's-Hertogenbosch, the Netherlands (A.J.G.K., M.B.J.M.K., T.S., M.R.); Department of Radiology, Meander Medisch Centrum, Amersfoort, the Netherlands (C.M.S.); and Thirona, Nijmegen, the Netherlands (R.H.H.M.P., A.M., J.M.).