Wilasrusmee et al reported the Ramathibody Appendicitis Score (RAMA-AS) for predicting appendicitis in a patient suspected of having appendicitis. The authors are from Ramathibodi Hospital, Thammasat University Hospital and Chalyaohum Hospital.
Patient selection: age 15 to 60 years with right-sided abdominal pain
Parameters:
(1) migration of pain
(2) progression of pain
(3) aggravation of pain by cough or movement
(4) body temperature
(5) rebound tenderness
(6) white blood cell count per µL
(7) percent neutrophils in differential count
Parameter
Finding
Points
migration of pain
no
0
yes
0.8
progression of pain
no
0
yes
1.04
aggravation of pain by cough or movement
no
0
yes
0.78
body temperature
< 37.8°C
0
>= 37.8°C
1.64
rebound tenderness
no
0
yes
1.54
white blood cell count
<= 10,000 per µL
0
> 10,000 per µL
0.91
percent neutrophils
<= 75%
0
> 75%
0.69
X =
= SUM(points for all 7 parameters) - 3.37
probability of appendicitis =
= 1 / (1 + EXP((-1) * X))
Performance:
• The area under the ROC curve is 0.85.
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