Clinical Indicators for Differential Diagnosis of Acute Lower Abdominal Pain in Women of Reproductive Age
Bibliographic record
Abstract
Background: Acute lower abdominal pain in women of reproductive age is a challenging condition for clinical diagnosis. Computerized tomography yields high accuracy, but may not be cost-effective in low-middle income countries. Selective diagnostic approach based on clinical findings may be more appropriate. Methods: Medical record review was performed on patients aging between 15 - 50 years who admitted to the surgical department or obstetrics and gynecology (OB-GYN) unit because of acute lower abdominal pain during January to December 2008. Patients were eventually categorized into appendicitis, OB-GYN conditions, or non-specific abdominal pain (NSAP). Clinical indicators were studied for diagnostic values using polytomous logistic regression applied to likelihood ratio for positive test (LR + ) and confidence interval (CI). Results: Anorexia, nausea and vomiting, shifting of abdominal pain decreased the likelihood of OB-GYN conditions. Diarrhea increased the likelihood of NSAP. Right lower quadrant tenderness increased the likelihood of appendicitis but decreased the likelihood of OB-GYN conditions. Left lower quadrant tenderness decreased the likelihood of appendicitis but increased the likelihood of OB-GYN. Guarding or rebound tenderness increased the likelihood of appendicitis but reduced the likelihood of NSAP. Leucocytosis (white blood cell count >= 10,000) increased the likelihood of appendicitis but reduced the likelihood of OB-GYN and NSAP. Neutrophil >= 75% increased the likelihood of OB-GYN but decreased the likelihood of NSAP. Pregnancy reduced the likelihood of appendicitis and increased the likelihood of OB-GYN. Conclusion: Gastrointestinal symptoms, sites of abdominal tenderness, guarding or rebound tenderness, leucocytosis, neutrophil >= 75% and pregnancy are clinical indicators that may help differentiating appendicitis, common OB-GYN conditions, or NSAP in acute lower abdominal pain in women of reproductive age. doi: http://dx.doi.org/10.4021/jcs179w
Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.
How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.001 | 0.011 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 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 source (direct Gemma or distilled Codex), 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".