الفهرس 
IntroductionOnly 14 pages are availabe for public view
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Abstract
Background: Acute appendicitis is the most common surgical condition of children. About 1 to 10% of children presenting in surgical emergencies with acute abdomen fall within the domain of acute appendicitis.
Aim and objectives: to perform a systematic review and a meta-analysis about literature published in the period from 2010-2023 determine the value of Clinical Scoring system and Imaging modalities To reduce Negative appendectomy Rate.
Subjects and methods: Meta-analysis and systematic review of the published studies about the role of clinical scoring systems and imaging modalities to reduce the negative appendectomy rate as comparing between patients operated as appendectomy with pre-operative assessment using clinical scoring systems and imaging modalities and those operated without preoperative assessment as regards the negative appendectomy rate carried out in the period between 2010 and 2023
Result: Four studies reported modified Alvarado scores (for 1 – 4 and 1 – 6 score) but only three studies suitable for analysis. A significant heterogeneity was detected. Therefore, a random-effect model was used for analysis (I² = 77%, P=0. 01). The combined OR and 95% CIs was 59.20 (7.32 to 478.73). The combined result demonstrates a statistically significant difference between groups regarding modified Alvarado scores (1 – 4 and 1 – 6 score) (Z = 3.83, P =0.0001).
Conclusion: Both scoring systems can be of assistance in setting the diagnosis of acute appendicitis, but none has adequate predictive values in assessing acute appendicitis, and none can be used as an exclusive standard in setting the diagnosis of acute appendicitis in children.
The AIR score had the best distinguishable power and statistically is superior to Alvarado score and PAS in prognostication of acute appendicitis in children population. Usage of AIR score in the diagnosis of suspected acute appendicitis in pediatrics increases clinical accuracy and reduces the negative appendicectomy rate. This results in a decrease in unnecessary admissions, the healthcare burden and cost and increases the overall efficiency of emergency surgical services.