A short-cut systematic review was carried out to establish whether the Alvarado score could be used to rule in or rule out a diagnosis of appendicitis in children. A literature search identified eight studies that were directly relevant to the question. The author, date and country of publication, patient group studied, study type, relevant outcomes, results and study weaknesses of these papers are tabulated. The clinical bottom line is that the Alvarado score does effectively risk stratify children with suspected appendicitis. Children with an Alvarado score of less than 5 are unlikely to have acute appendicitis, although wide confidence intervals mean that more evidence is still needed before this alone can be used to exclude the diagnosis.
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