Title:

“Which are the most Effective CT Protocols in the Diagnosis of Acute Appendicitis in Children?”

Aim:

“To Review the Best CT Protocols For Accurate Diagnosis of Acute Appendicitis in Children”

Objectives:

1. To determine and appraise the most effective CT protocols in the detection of acute appendicitis in children;
2. To establish the effectiveness of different CT protocols in the detection of acute appendicitis in children.

Literature Review Process

Having had the research study topic and research aims approved by the module advisers, a myriad of search approaches were employed to identify an appropriate database that would provide critical information relevant to the research area of interest. In pursuit of this, the researcher identified various key words that were critical in identifying pertinent articles, journals and books that would provide the needed information.

The study predominantly used journal articles because they are based on research studies and had to go through rigorous, in-depth analysis before publication in the peer reviewed journals. Journals that were especially invaluable in the course of the research study touched on roentgenology, medical diagnosis of appendicitis, paediatric ailments, and computed tomography scan, terms which formed the key search words. These terms were slowly introduced into the search engine to polish up the search results until appropriate articles were identified that matched with the research topic and aims of the research study topic.Other key research terms that were further included in the course of the research were imaging/ radiology, acute appendicitis, diagnostic value, CT in children; Radiology, Ultrasonography, Neuroradiology, CT protocols. The inclusion of these search terms filtered the search results further

The GCU library was the predominant database that facilitated access to appropriate journals such as the Journal of Radiology, Journal of Paediatric Radiology, and the British Institute of Radiology. Other databases included the Radiological Society of North America Journals (RSNA) and the American Journal of Roentgenology.During the first search   on the GCU library 5675 results were obtained. Using the filter options provided by the database and introduction of additional search terms, as well as limitation of the searches to journal artcicles and books and official reports, the search yielded 2342 hits. Further limiting the search to peer reviewed journal articles that are written in English the results yielded 347 relevant sources.

A quick perusal of the abstracts of the search results reflected the inclusion of some sources that were not very applicable to the research topic. However, they would be critical during the course of the research study in providing associated information on the research topic.Due to the fact that the there has been very limited recent research in the field of CT Protocols in the Diagnosis of Acute Appendicitis in Children, the research study limits itself to journals articles, reports and book published within the past eight years.

                                Critical Methodological Appraisal

One of the sources selected as a source for the research study is titled “US or CT for Diagnosis of Appendicitis in Children and Adults” authored byDoria, et al.(2006), published by the Radiological Society of North America. The validity of the article stems from the facts that it was published in a very credible peer reviewed journal, the authors are affiliated with nationally recognised medical bodies thatare highly regarded institutions in the field of radiology; and the authors choice of sources and references reflected credible researches conducted in the field of radiology. The study was a qualitative research study that relied heavily on medical literature; it also included prospective and retrospective studies.The study aimed at analysing the effectiveness of CT as opposed to US in the diagnosis of appendicitis in children.This source is critical for the study as it provided important information on the use, applicability and accuracy of CT scan in children, which forms the core subject of the research study.

The second source that has been used to enrich the research topic is from the Journal of the American College of Surgeons (2009). The article is titled “Improving Diagnosis of Acute Appendicitis: Results of a Diagnostic Pathway with Standard Use of Ultrasonography Followed by Selective Use of CT.”  This study was included since it was a qualitative study that aimed at assessing the accuracy of a diagnostic pathway in acute appendicitis using US and complementary Contrast-enhanced multi-detector CT, both of which are variables that are of interest in the research topic.With regards to the study design, one hundred and fifty-one participants with clinically suspected appendicitis followed the designed protocol. The results of US and CT experiments were correlated with surgical findings, histopathology and follow up. The validity and reliability of this source can be accredited to its use of a highly recommendable study design and research methodology in terms of study participants and approach of conducting the experiment.

References

Doria, A. S., Moineddin, R., Kellenberger, C. J., Epelman, M., Beyene, J., Schuh, S., . . . Dick, P. T. (2006). US or CT for Diagnosis of Appendicitis in Children and Adults? A Meta-Analysis. Journal of the American College of Surgery.

Poortman, P., Oostvogel, H. J., Bosma, E., Lohle, P. N., Cuesta, M. A., Lange-de Klerk, E. S., & Hamming, J. F. (2009). Improving Diagnosis of Acute Appendicitis: Results of a Diagnostic Pathway with Standard Use of Ultrasonography Followed by Selective Use of CT. Journal of the American College of Surgery, 208(3). Retrieved Novemebr 8, 2014

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