Concordance between RIPASA and ALVARA DO scoring system for the diagnosis of acute appendicitis peri-ampullary carcinomas

To determine the diagnostic accuracy of RIPASA and ALVARA DO scoring system by taking histopathology as gold standard. Materials and methods: Th is was a cross-sectional study in which total of 201 patients who were presented with right iliac fossa pain were enrolled. Non-probability sampling technique was employed. Th e RIPASA and ALVARA DO scores were derived and decisions based on clinical judgement was done. Aft er appendectomies, resected appendix was sent for histopathological examination by consultant pathologist. SPSS version 23 was used for statistical analysis. Sensitivity, specificity, positive predicted value, negative predicted value & diagnostic accuracy were calculated. Results:At optimal cutoff threshold for RIPASA score≥7.5, the sensitivity, specificity, positive predictive value, negative predictive value & diagnostic accuracy of the RIPASA scoring system were calculated as 100%, 96.23%, 98.67%, 100% & 99% respectively.Similarly, at optimal cutoff threshold for ALVARA DOscore≥7 the sensitivity, specificity, positive predictive value, negative predictive value & diagnostic accuracy of the Alvarado scoring system were 95.95%, 92.45%, 97.26%, 89.09% and 95.02% respectively. Conclusion: RIPASA is more accurate and useful diagnosing tool for detection of appendicitis compared to ALVARA DO. (author)