Identification of Pediatric Retrocecal Appendicitis Using Point of Care Ultrasound (POCUS)
Bibliographic record
Abstract
Acute appendicitis is the most common pediatric surgical emergency. Diagnosis may be made by targeted point of care ultrasound (POCUS) of the right lower quadrant (RLQ) abdomen. This can be performed by trained emergency physicians and has similar accuracy to ultrasound performed by radiology technologists and interpreted by radiologists (RADUS) [1,2]. Pediatric patients with appendicitis may present without classical clinical signs and symptoms. Retrocecal appendicitis is often diagnosed late at perforation due to the anatomical position limiting diagnosis with ultrasound, despite the high prevalence of retrocecal appendix as an anatomic variation (up to 65%). Given the limited sensitivity for ultrasound in the diagnosis of appendicitis in patients with retrocecal appendix, these patients often undergo advanced imaging with computed tomography (CT) or magnetic resonance imaging (MRI), especially when increased abdominal wall thickness and/or high Body Mass Index (BMI) further limit the ultrasound examination [4-6]. We present a case series of retrocecal appendicitis imaged and diagnosed with POCUS, using novel transducer and patient positioning. In addition to standard graded compression of the RLQ with POCUS, this technique may add to the diagnostic accuracy of patients presenting atypically with anatomic variants.
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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 | 0.000 | 0.000 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.000 |
| 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".