1) What is the diagnostic accuracy of computed tomography compared to ultrasound for the detection of suspected acute appendicitis in adult patients?
Studies will be included if they prospectively evaluated adult patients with suspected appendicitis using computed tomography and/or ultrasound as a first-line imaging modality, followed by surgical/histopathologic confirmation. Studies focused on pediatric or pregnant patients will be excluded.
Computed Tomography (CT). No stipulation regarding the specific nature of imaging will be implemented, which is not limited to variables such as the equipment, technique, scanning protocol, location and time-to-imaging. CT imaging therefore could include contrast or non-contrast scans.
Ultrasound (may comprise common approaches such as POCUS, bedside or general clinical sonography). If there exists sufficient variation in these subgroups across eligible studies, subgroup analysis will be undertaken.
This review will consider any quantitative study that examines outcomes of interest such specificity, sensitivity, negative predictive value, positive predictive value, odds ratio and receiver-operator characteristic (ROC) in the diagnosis of AA. Like many studies in the radiology field, one should endeavor to deduce whether the diagnostic tool exhibits accuracy, whilst demonstrating consideration of whether other important radiologic factors are justified; therefore, qualitative discussion of clinically relevant aspects such as radiation dose, cost and accessibility will supplement this systematic review to provide assistance to practitioners when making important decisions wherever these aspects become relevant in the clinical setting.