The Dynamic Global Incidence of Acute Appendicitis: A Systematic Review of International Temporal Trends
Bibliographic record
Abstract
Purpose: Appendicitis is an important cause of the acute surgical abdomen in the developed world, and increasingly in developing countries. Broad-ranging incidence rates have been reported geographically over time. We conducted a systematic review of the literature to assess temporal changes in incidence rates and to evaluate global variations. Methods: Articles were obtained by performing a computerized literature search of EMBASE (1980 to January 2010) and MEDLINE (1950 to December 2009) electronic databases and a review of the reference lists of relevant studies, with no language restrictions. Two reviewers identified eligible articles based on the following pre-determined criteria: (1) identified a cohort of appendicitis patients; (2) reported or provided enough information to calculate incidence rates; and (3) published in full manuscript form. Included articles reported incidence of acute appendicitis or appendectomy, with or without age and sex distributions. Incidence maps were created to show the international rates of appendicitis over time. Results: The literature search yielded 5,154 references and the review resulted in 80 included studies. Of these, 65 reported overall incidence of appendicitis and 15 were included because they described appendicitis incidence by age or sex groupings. The geographic areas studied varied with 60% of the studies from Europe, 17.5% from North America, 11.3% from Africa, 7.5% from Asia and 3.7 % from Australia. The European studies were published between 1932 and 2005 showed appendicitis incidence rates that ranged from 10 to 1040 per 100,000. 33% of these studies assessed time trends with 94% reporting decreasing incidence of appendicitis over time. North American studies from 1937 to 2004 reported incidence rates that ranged from 58 to 383 per 100,000. 21% of these studies assessed time trends with 67% reporting decreasing incidence over time. African studies from 1960 to 2004 showed incidence rates that ranged from 3 to 77 per 100,000. No time trend analyses were performed; however, the more recent publications reported higher incidence rates. Asian studies from 1973 to 2002 showed incidence rates that ranged from 13 to 200 per 100,000. 33% assessed time trend analyses with 100% showing increasing incidence over time. Australian studies from 1940 to 1990 showed incidence rates that ranged from 17 to 320 per 100,000. 67% showed time trend analyses over time with 100% showing decreasing incidence over time. Conclusion: There is high geographical variability in the temporal incidence of appendicitis with a trend for decreasing appendicitis incidence in North America, Europe and Australia and a trend for increasing appendicitis incidence rates in Asia and Africa.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.002 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.005 | 0.001 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.001 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.001 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".