ACR Appropriateness Criteria® Acute (Nonlocalized) Abdominal Pain and Fever or Suspected Abdominal Abscess EVIDENCE TABLE Reference 1.
Patients/ Events N/A
Study Objective (Purpose of Study) Review data on cost effectiveness and diagnostic accuracy of unenhanced helical CT in acute abdominal pain. Prospective observational study to: 1) determine if older patients with abdominal pain who receive emergency department abdominal CT have changes in diagnosis and/or disposition more often than similar patients without CT; 2) compare physician confidence in diagnosis and disposition for patients with vs without CT; and 3) document factors that most influence physician's decision to order abdominal CT in this population.
Mindelzun RE, Jeffrey RB. Unenhanced helical CT for evaluating acute abdominal pain: a little more cost, a lot more information. Radiology 1997; 205(1):4345. Lewis LM, Klippel AP, Bavolek RA, Ross LM, Scherer TM, Banet GA. Quantifying the usefulness of CT in evaluating seniors with abdominal pain. Eur J Radiol 2007; 61(2):290-296.
Yeh EL, McNamara RM. Abdominal pain. Clin Geriatr Med 2007; 23(2):255270, v.
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To review abdominal pain in the elderly, discuss the clinical approach, and highlight key diagnostic considerations.
Study Results Helical CT provides clinically relevant information at a reasonable cost.
Abdominal CT rate was 59% (95% CI, 50%67%). CT was associated with an increased change in diagnosis (46%; 95%CI, 4%-58% vs 29%; 95% CI, 16%-42%), but no change in disposition between patients with vs without CT. Preliminary diagnostic confidence was lower for emergency physicians who ordered a CT than for those who did not (P