Value of C-reactive protein, white blood cells and neutrophils to distinguish appendicitis in pediatric patients
Bibliographic record
Abstract
Abstract The value for ordering laboratory tests like CRP for appendicitis in children is debatable. The objective of this study was to determine the diagnostic utility of CRP, WBC, and NP to differentiate acute and perforated appendicitis. A retrospective cohort study of pediatric patients referred for appendicitis at CHEO from January 2016 to January 2019 was conducted. Comparisons of laboratory test results were made using the Wilcoxon rank sum test. ROC curves were used to examine diagnostic utility. One hundred and eighty (101 male) of 899 children with appendicitis had CRP, WBC, and NP levels available with a median age of 11.1 (8.1, 13.7) years. There were 93 (51.7%) patients with acute appendicitis and 87 (48.3%) were perforated. The median CRP level for patients with acute appendicitis was 20.3 (6.9, 38.3) versus 65.3 (48.7, 180.8) for perforated appendicitis (p <0.001). The area under the ROC curve for CRP was 85.1 % (95% C.I. 79.5-90.7), higher than that of WBC’s 68.1 % (95% C.I. 60.1- 76.1). Our study demonstrates that CRP can achieve good sensitivity without compromising specificity. These findings suggest that CRP performs better than WBC and NP in terms of discriminating between acute versus perforated appendicitis.
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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 | 0.006 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.001 | 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".