Abstract：
OBJECTIVE: Acute appendicitis is one of the most commonly encountered surgical emergencies on a global level. Due to the requirement of an immediate clinical diagnosis and the presence of limited resources, clinicians and diagnosticians refer to scoring systems to diagnose this condition, among which Alvarado and Tzanakis scoring systems are widely used. This meta-analysis aims to compare the diagnostic accuracy of these two systems.
METHODS: We searched PubMed, Google Scholar, and SCOPUS databases. All studies that reported diagnostic parameters of Alvarado and Tzanakis scores in patients with suspected acute appendicitis were selected. Diagnostic values such as sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were extracted from the selected studies and statistical analysis was performed with Meta Disc 1.4 software. Quality assessment of the selected studies was performed using the QUADAS-2 and QUADAS-C tools. Fourteen studies were included in our meta-analysis which enrolled 2235 patients.
RESULTS: The overall sensitivity of the Tzanakis score was calculated as 0.86 (95% CI; 0.84-00.87) while the specificity was 0.73 (95% CI; 0.69-0.78). In addition, the area under the curve (AUC) was 0.9261 (SE; 0.0169) and the diagnostic Odds Ratio (OR) was 22.52 (95% CI; 9.47-53.56). The pooled sensitivity of Alvarado score was 0.67 (95% CI; 0.65-0.69) and the specificity was 0.74 (95% CI; 0.69-0.79). Moreover, the area under the curve (AUC) of the Alvarado score was 0.7389 (SE; 0.0489) and the diagnostic Odds Ratio was 4.92 (95% CI; 2.48-9.75).
CONCLUSIONS: The Tzanakis scoring system has a higher sensitivity, area under the curve, and diagnostic odds ratio when compared to the Alvarado score. However, the Alvarado score has a marginally better specificity making it more reliable in excluding acute appendicitis.
METHODS: We searched PubMed, Google Scholar, and SCOPUS databases. All studies that reported diagnostic parameters of Alvarado and Tzanakis scores in patients with suspected acute appendicitis were selected. Diagnostic values such as sensitivity, specificity, positive predictive value (PPV), negative predictive value (NPV), and diagnostic accuracy were extracted from the selected studies and statistical analysis was performed with Meta Disc 1.4 software. Quality assessment of the selected studies was performed using the QUADAS-2 and QUADAS-C tools. Fourteen studies were included in our meta-analysis which enrolled 2235 patients.
RESULTS: The overall sensitivity of the Tzanakis score was calculated as 0.86 (95% CI; 0.84-00.87) while the specificity was 0.73 (95% CI; 0.69-0.78). In addition, the area under the curve (AUC) was 0.9261 (SE; 0.0169) and the diagnostic Odds Ratio (OR) was 22.52 (95% CI; 9.47-53.56). The pooled sensitivity of Alvarado score was 0.67 (95% CI; 0.65-0.69) and the specificity was 0.74 (95% CI; 0.69-0.79). Moreover, the area under the curve (AUC) of the Alvarado score was 0.7389 (SE; 0.0489) and the diagnostic Odds Ratio was 4.92 (95% CI; 2.48-9.75).
CONCLUSIONS: The Tzanakis scoring system has a higher sensitivity, area under the curve, and diagnostic odds ratio when compared to the Alvarado score. However, the Alvarado score has a marginally better specificity making it more reliable in excluding acute appendicitis.
摘要：
目的：急性阑尾炎是全球范围内最常见的外科急症之一。由于需要立即进行临床诊断和资源有限，临床医生和诊断医生参考评分系统来诊断这种情况，其中Alvarado和Tzanakis评分系统被广泛使用。本荟萃分析旨在比较这两种系统的诊断准确性。
方法：我们搜索了PubMed，谷歌学者，和SCOPUS数据库。选择了所有报告疑似急性阑尾炎患者的Alvarado和Tzanakis评分诊断参数的研究。诊断值，如灵敏度，特异性，阳性预测值(PPV)，负预测值(NPV)，从所选择的研究中提取诊断准确性，并使用MetaDisc1.4软件进行统计分析。使用QUADAS-2和QUADAS-C工具对所选研究进行质量评估。我们的荟萃分析包括14项研究，共纳入2235例患者。
结果：Tzanakis评分的总体敏感性计算为0.86（95％CI;0.84-00.87），而特异性为0.73（95％CI;0.69-0.78）。此外,曲线下面积(AUC)为0.9261(SE;0.0169),诊断几率(OR)为22.52(95%CI;9.47~53.56).Alvarado评分的合并敏感性为0.67（95％CI;0.65-0.69），特异性为0.74（95％CI;0.69-0.79）。此外，Alvarado评分的曲线下面积(AUC)为0.7389(SE;0.0489),诊断几率为4.92(95%CI;2.48~9.75).
结论：Tzanakis评分系统具有更高的灵敏度，曲线下的面积,与Alvarado评分相比的诊断优势比.然而,Alvarado评分的特异性略好,在排除急性阑尾炎方面更可靠.
方法：我们搜索了PubMed，谷歌学者，和SCOPUS数据库。选择了所有报告疑似急性阑尾炎患者的Alvarado和Tzanakis评分诊断参数的研究。诊断值，如灵敏度，特异性，阳性预测值(PPV)，负预测值(NPV)，从所选择的研究中提取诊断准确性，并使用MetaDisc1.4软件进行统计分析。使用QUADAS-2和QUADAS-C工具对所选研究进行质量评估。我们的荟萃分析包括14项研究，共纳入2235例患者。
结果：Tzanakis评分的总体敏感性计算为0.86（95％CI;0.84-00.87），而特异性为0.73（95％CI;0.69-0.78）。此外,曲线下面积(AUC)为0.9261(SE;0.0169),诊断几率(OR)为22.52(95%CI;9.47~53.56).Alvarado评分的合并敏感性为0.67（95％CI;0.65-0.69），特异性为0.74（95％CI;0.69-0.79）。此外，Alvarado评分的曲线下面积(AUC)为0.7389(SE;0.0489),诊断几率为4.92(95%CI;2.48~9.75).
结论：Tzanakis评分系统具有更高的灵敏度，曲线下的面积,与Alvarado评分相比的诊断优势比.然而,Alvarado评分的特异性略好,在排除急性阑尾炎方面更可靠.
