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CompletedNCT07804238DV-AAA ELHTUpdated Sep 4, 2026

Comparative Study on the Diagnostic Validity of the Alvarado Score, Appendicitis Inflammatory Response (AIR), and Adult Appendicitis Score (AAS) in Acute Appendicitis at East Lancashire Hospitals NHS Trust (ELHT)

An observational study in Acute Appendicitis, sponsored by East Lancashire Hospitals NHS Trust. Completed at 1 site in United Kingdom. Open to participants aged 16 Years and older. Per ClinicalTrials.gov, last updated 2026-09-04.

Sponsored by East Lancashire Hospitals NHS Trust · Observational

Study type
Observational
Model
Cohort
Time perspective
Retrospective
Enrollment
300
Ages
16 Years and older
Sex
All
01

Study summary

This retrospective observational study aims to compare the diagnostic accuracy of Alvarado Score, Appendicitis Inflammatory Response (AIR) Score, and Adult Appendicitis Score (AAS) in predicting histologically confirmed acute appendicitis in adult patients presenting to East Lancashire Hospitals NHS Trust (ELHT). The study will include all emergency patients aged 16 years and above, of any gender, admitted between June 2023 and June 2024 with clinical suspicion of acute appendicitis who subsequently underwent appendicectomy via laparoscopic or open approaches. For each patient, the Alvarado, AIR, and AAS scores will be calculated retrospectively using information from presenting symptoms, physical examination findings, and laboratory investigations recorded at the time of admission. These calculated scores will be compared against the final histopathology results, which serve as the gold standard for diagnosis. Diagnostic performance will be assessed using sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV). Sensitivity reflects the proportion of patients with appendicitis correctly identified by the score, while specificity measures the ability to correctly exclude those without the condition. PPV indicates the likelihood that a positive score truly represents acute appendicitis, whereas NPV represents the likelihood that a negative score accurately rules it out. Accurate and timely pre-operative diagnosis of acute appendicitis is essential to minimise the incidence of negative appendicectomies while avoiding unnecessary diagnostic investigations. This study also aims to determine the most effective scoring system for risk stratification in the local adult population, considering the demographic diversity, and to provide recommendations for the standardisation of appendicitis risk assessment tools in emergency surgical practice within the trust.

02

Conditions studied

  • Acute Appendicitis

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Keywords

  • Acute appendicitis
  • Alvarado score
  • Appendicitis Inflammatory Response (AIR) score
  • Adult Appendicitis Score (AAS)
  • Diagnostic accuracy
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Who can participate

Ages eligible
16 Years and older
Sexes eligible
All
Sampling method
Non-probability sample

Study population

All emergency patients of any gender and aged 16 and above who were admitted between June 2023 and June 2024 with a clinical suspicion of acute appendicitis and who subsequently underwent an appendicectomy (via laparoscopy, open surgery, or laparotomy).

Inclusion criteria

  • Patients of any gender
  • Patients aged 16 and above
  • Admitted as an emergency with suspected appendicitis
  • Must have undergone appendicectomy (laparoscopic, open, or laparotomy) from June 2023 to June 2024 at East Lancashire Hospitals NHS Trust

Exclusion criteria

Exclusion Criteria:

  • Patients who have undergone elective, interval, or incidental appendicectomies.
  • Patients younger than 16
04

Study design

Observational model
Cohort
Time perspective
Retrospective
Enrollment
300 participants (actual)
Patient registry
No

Groups and cohorts

  • ELHT Patient Population

    All emergency patients of any gender and aged 16 and above who were admitted between June 2023 and June 2024 with a clinical suspicion of acute appendicitis and who subsequently underwent an appendicectomy (via laparoscopy, open surgery, or laparotomy).

05

What researchers measure

Primary outcomes

  1. Diagnostic Accuracy

    Which scoring system - Alvarado Score, Appendicitis Inflammatory Response (AIR) Score or Adult Appendicitis Score (AAS) has the highest diagnostic accuracy for predicting histologically confirmed appendicitis among patients undergoing emergency appendicectomy? \[Diagnostic accuracy will be assessed by comparing their sensitivity, specificity, positive predictive value and negative predictive value. Receiver Operating Characteristic (ROC) analysis and Area Under the Curve (AUC) will be presented to assess the overall discriminative performance.\]

    Time frame: From initial clinical assessment at presentation to histological diagnosis following appendicectomy, is up to 6 months

06

Study locations

1 site
  • East Lancashire Hospitals NHS Trust
    Blackburn, Lancashire BB2 3HH, United Kingdom
07

References and documents

Study documents

  • Study protocol · Nov 19, 2025

Documents are hosted by the registry — open the source record to download them.

Individual participant data

Plan to share: No — There are no plans to release the anonymised participant-level dataset or statistical code for public access. However, data may be made available upon reasonable request to the Chief Investigator, subject to appropriate ethical and governance approvals and in line with ELHT information governance and data protection standards.

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Registry details

Key details

Study ID
NCT07804238
Lead sponsor
East Lancashire Hospitals NHS Trust
Responsible party
Sponsor
First posted
Sep 4, 2026
Start date
Apr 13, 2026
Primary completion
Jul 28, 2026
Completion
Jul 28, 2026
Last update
Sep 4, 2026

Oversight

Data monitoring committee
No
FDA-regulated drug
No
FDA-regulated device
No
View the source record on ClinicalTrials.gov ↗

Not currently enrolling

This study is completed, as verified in Sep 2026. You cannot join it, but the record below documents what was studied.

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