Signs and Evidence

Making clinical sense of scientific data

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Rebound tenderness

Appendicitis
 Positive likelihood ratio
3.00 ( David G. Bundy et )
2.41 ( Lamture YR et al. )
(average) 2.71
Negative likelihood ratio
0.28 ( David G. Bundy et )
0.48 ( Lamture YR et al. )
(average) 0.38
Cholecystitis
 Positive likelihood ratio
1.90 ( Trowbridge RL et al. )
1.70 ( Abraham S et al. )
(average) 1.8
Negative likelihood ratio
0.75 ( Trowbridge RL et al. )
0.43 ( Abraham S et al. )
(average) 0.59
Small bowel obstruction
 Positive likelihood ratio
5.10 ( Bohner H et al. )
(average) 5.1
Negative likelihood ratio
0.70 ( Bohner H et al. )
(average) 0.7
Cholelithiasis
 Positive likelihood ratio
1.30 ( Abraham S et al. )
(average) 1.3
Negative likelihood ratio
0.73 ( Abraham S et al. )
(average) 0.73


Sources used:

1.David G. Bundy et al. Does This Child Have Appendicitis? JAMA. 2007 Jul 25; 298(4): 438–451.
2.Trowbridge RL et al. Does This Patient Have Acute Cholecystitis? JAMA, January 1, 2003—Vol 289, No. 1 80-86
3.Bohner H et al. Simple data from history and physical examination help to exclude bowel obstruction and to avoid radiographic studies in patients with acute abdominal pain. Eur J Surg. 1998 Oct;164(10):777-84
4.Abraham S et al. Surgical and Nonsurgical Management of Gallstones. Am Fam Physician. 2014 May 15;89(10):795-802
5.Lamture YR et al. The role of rebound tenderness in acute appendicitis and appendicular perforation. Int Surg J. 2017 Feb;4(2):725-727