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Trial registered on ANZCTR
Registration number
ACTRN12614001043628
Ethics application status
Approved
Date submitted
14/09/2014
Date registered
26/09/2014
Date last updated
1/03/2016
Type of registration
Prospectively registered
Titles & IDs
Public title
Comparison between Modified Alvarado and Raja Isteri Pengiran Anak Saleha (RIPAS) Scores in the Diagnosis of Acute Appendicitis in Adults Among Population of Southern Region of Saudi Arabia.
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Scientific title
Comparison between Modified Alvarado and Raja Isteri Pengiran Anak Saleha (RIPAS) Scores in the Diagnosis of Acute Appendicitis in Adults Among Population of Southern Region of Saudi Arabia in terms of accuracy of diagnosis.
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Secondary ID [1]
285335
0
nil
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Universal Trial Number (UTN)
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Trial acronym
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Linked study record
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Health condition
Health condition(s) or problem(s) studied:
Acute Appendicitis
293062
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Condition category
Condition code
Surgery
293333
293333
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0
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Other surgery
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Oral and Gastrointestinal
293392
293392
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0
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Other diseases of the mouth, teeth, oesophagus, digestive system including liver and colon
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Intervention/exposure
Study type
Interventional
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Description of intervention(s) / exposure
Both modified Alvarado and RIPASA scores will be fulfilled by the research team for patients who are going to be operated for acute appendicitis in the preoperative period.
Modified Alvarado Score
Symptoms
Migration of pain to the right lower quadrant 1
Anorexia 1
Nausea/Vomiting 1
Signs
Tenderness in the right iliac fossa 2
Rebound tenderness in the right iliac fossa 1
Elevated temperature (>37,3 degrees Centigrade) 1
Investigations
Leukocytosis (>10.000/ml) 2
Total
RIPASA
Demographic data
Male 1.0
Female 0.5
Age < 39.9 years 1.0
Age greater than or equal 40 years 0.5
Symptoms
RIF pain 0.5
Migration of RQP 0.5
Anorexia 1.0
Nausea / Vomiting 1.0
Duration of Symptoms < 48 hrs 1.0
Duration of Symptoms > 48 hrs 0.5
Signs
RIF tenderness 1.0
RIF guarding 2.0
Rebound tenderness 1.0
Rovsing’s sign 2.0
Fever >37 - < 39 degrees Centigrade 1.0
Investigations
Raised WBCs 1.0
Negative Urinalysis 1.0
Additional scores
Foreign ID 1.0
Total
Both scores will be calculated for each patient by summation of the points of positive finding, then sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for both scoring systems will be calculated.
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Intervention code [1]
290249
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Diagnosis / Prognosis
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Comparator / control treatment
Modified Alvarado and RIPASA Scores for diagnosing acute appendicitis. both scores are compared to operative findings and postoperative histopathology then sensitivity, specificity, positive predictive value (PPV) and negative predictive value (NPV) for both scoring systems will be calculated.
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Control group
Active
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Outcomes
Primary outcome [1]
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Accuracy of diagnosing acute appendicitis
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Assessment method [1]
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Timepoint [1]
293164
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detected by the doctor by comparing the preoperative Modified Alvarado and RIPASA Scores with operative findings and postoperative histopathology
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Secondary outcome [1]
310475
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nil
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Assessment method [1]
310475
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Timepoint [1]
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nil
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Eligibility
Key inclusion criteria
All patients older than 13 years who will undergo appendectomy will be included in the study.
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Minimum age
13
Years
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Maximum age
No limit
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Sex
Both males and females
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Can healthy volunteers participate?
No
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Key exclusion criteria
Patients below 13 years are treated by the pediatric team according to the policy of our hospital and will be excluded from the study.
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Study design
Purpose of the study
Diagnosis
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Allocation to intervention
Non-randomised trial
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Procedure for enrolling a subject and allocating the treatment (allocation concealment procedures)
All patients older than 13 years who will undergo appendectomy will be included in the study
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Methods used to generate the sequence in which subjects will be randomised (sequence generation)
nil
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Masking / blinding
Open (masking not used)
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Who is / are masked / blinded?
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Intervention assignment
Single group
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Other design features
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Phase
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Type of endpoint/s
Efficacy
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Statistical methods / analysis
Sample size was calculated according to Dahiru et al to be 60 patients with Za=1.96, expected prevalence of correctly diagnosed cases of appendicitis is 85%, and accepted error of 0.09
Paired t test will be used to compare between both scores.,Chi-Square test was applied for qualitative data (Fisher exact test was used when appropriate). A statistically significant p-value was considered at p<0.05
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Recruitment
Recruitment status
Completed
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Date of first participant enrolment
Anticipated
1/10/2014
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Actual
1/10/2014
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Date of last participant enrolment
Anticipated
30/11/2014
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Actual
3/02/2015
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Date of last data collection
Anticipated
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Actual
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Sample size
Target
60
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Accrual to date
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Final
60
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Recruitment outside Australia
Country [1]
6353
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Saudi Arabia
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State/province [1]
6353
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Asir/ Abha
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Funding & Sponsors
Funding source category [1]
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Self funded/Unfunded
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Name [1]
289951
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Address [1]
289951
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Country [1]
289951
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Primary sponsor type
University
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Name
King Khalid University
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Address
Greiger
Zip: 61421
P.O.: 641
Abha
Saudi Arabia
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Country
Saudi Arabia
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Secondary sponsor category [1]
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Hospital
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Name [1]
288641
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Aseer Central Hospital
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Address [1]
288641
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King Abdullah Road
PO Box 34
Zip: 62523
Abha
Saudi Arabia
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Country [1]
288641
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Saudi Arabia
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Ethics approval
Ethics application status
Approved
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Ethics committee name [1]
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Ethical Committee of King Khalid University
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Ethics committee address [1]
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Saudi Arabia Abha Greiger King Khalid University, Building C Ethical Committee PO 641, Zip 61421
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Ethics committee country [1]
294540
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Saudi Arabia
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Date submitted for ethics approval [1]
294540
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06/06/2014
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Approval date [1]
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30/11/2014
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Ethics approval number [1]
294540
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REC # 2014-06-06
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Summary
Brief summary
Absolute diagnosis of acute appendicitis is only possible with histopathology results after appendectomy. On the other hand, the decision to perform surgery is based solely on clinical evaluation supplemented by laboratory data. Therefore diagnostic errors are common, resulting in a median incidence of perforation of 20% and a negative laparotomy rate ranging from 2% to 30%. So aim of our study is to compare Modified Alvarado score versus RIPASA score in diagnosing acute appendicitis among middle eastern population in Aseer region (southern region of Saudi Arabia).
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Trial website
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Trial related presentations / publications
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Public notes
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Attachments [1]
792
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/AnzctrAttachments/367095-Ethical approval.pdf
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Contacts
Principal investigator
Name
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A/Prof Walid Abd El Maksoud MD, MRCS
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Address
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King Khalid University, Abha, Saudi Arabia
Faculty of Medicine
Department of General Surgery
Zip: 61421
P.O.: 641
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Country
51438
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Saudi Arabia
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Phone
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+966543128555
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Fax
51438
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Email
51438
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[email protected]
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Contact person for public queries
Name
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Walid Abd El Maksoud MD, MRCS
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Address
51439
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King Khalid University, Abha, Saudi Arabia
Faculty of Medicine
Department of General Surgery
Zip: 61421
P.O.: 641
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Country
51439
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Saudi Arabia
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Phone
51439
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+966543128555
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Fax
51439
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Email
51439
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[email protected]
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Contact person for scientific queries
Name
51440
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Walid Abd El Maksoud MD, MRCS
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Address
51440
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King Khalid University, Abha, Saudi Arabia
Faculty of Medicine
Department of General Surgery
Zip: 61421
P.O.: 641
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Country
51440
0
Saudi Arabia
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Phone
51440
0
+966543128555
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Fax
51440
0
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Email
51440
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[email protected]
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No information has been provided regarding IPD availability
What supporting documents are/will be available?
No Supporting Document Provided
Results publications and other study-related documents
Documents added manually
No documents have been uploaded by study researchers.
Documents added automatically
No additional documents have been identified.
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