The goal of this clinical trial is to compare protocol based selective imaging to routine imaging in adult patients with suspected appendicitis. The main question\[s\] it aims to answer are: * Does protocol based selective imaging using clinical scoring affect clinical outcome? * Does protocol based selective observation combined with score based selective imaging affect clinical outcome? Participants will be randomized into three groups: * Selective imaging based on Adult Appendicitis Score * Selective observation based on Appendicitis Severity Score combined with selective imaging based on Adult Appendicitis Score * Routine imaging using ultrasound and/or computed tomography Researchers will compare selective imaging groups separately with routine imaging to see if number of negative appendectomies or number of complicated appendicitis is not significantly increased.
Study Type
INTERVENTIONAL
Allocation
RANDOMIZED
Purpose
DIAGNOSTIC
Masking
NONE
Enrollment
900
Abdominal ultrasound and/or abdominal CT
Abdominal imaging is done selectively based on Adult Appendicitis Score
Observation based on Appendicitis Severity Score combined Adult Appendicitis Score based selective abdominal imaging
HUS, Jorvi Hospital
Espoo, Finland
RECRUITINGHUS, Meilahti Hospital
Helsinki, Finland
RECRUITINGHUS, Hyvinkää Hospital
Hyvinkää, Finland
RECRUITINGNegative appendectomy
Number of negative appendectomies (surgical removal of non-inflamed appendix)
Time frame: Within 30 days from randomization
Complicated appendicitis
Number of patients with complicated appendicitis (AAST grade 3 or higher)
Time frame: Within 30 days from randomization
histologically proven appendicitis
Number of patients with histologically proven appendicitis undergoing surgery
Time frame: Within 30 days from randomization
CT scan
Number of patients having abdominal computed tomography
Time frame: Within 30 days from randomization
Adverse events
Number patients with of adverse events (surgical complications, surgical site infections or delayed significant diagnosis)
Time frame: Within one year from randomization
Appendicitis
Number of patients diagnosed with appendicitis
Time frame: Within 2 years from randomization
Quality of life (EQ-5D-5L index value)
Quality of life determined by weekly EQ-5D-5L index values.
Time frame: During the first 30 days from randomization
Quality of life (EQ-5D-5L EQ-VAS score)
Quality of life determined by weekly EQ-5D-5L EQ-VAS score.
Time frame: During the first 30 days from randomization
Costs in Euros
Overall costs of diagnostics and treatment
Time frame: During the first 30 days from randomization
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