ARCHETYPE Alvarado score (openEHR-EHR-OBSERVATION.alvarado_score.v0)

ARCHETYPE IDopenEHR-EHR-OBSERVATION.alvarado_score.v0
ConceptAlvarado score
DescriptionClinical scoring system used to determine the likelihood of appendicitis based on symptoms, signs and laboratory test results.
UseUse to determine the likelihood of appendicitis based on symptoms, signs and laboratory test results. The total score, derived by adding up the individual scores for each of the 8 items ranges from 0 to 10 with score weights allocated thus: +2 points - Right lower quadrant tenderness +1 point - Elevated temperature (>37.3°C or 99.1°F) +1 point - Rebound tenderness +1 point - Migration of pain to the right lower quadrant +1 point - Anorexia +1 point - Nausea or vomiting +2 point - Leukocytosis > 10,000 +1 point - Leukocyte left shift - A CT scan is recommended for scores 4-6 - A surgical consultation for scores ≥ 7. - For scores ≤ 3: a CT scan is not needed due to the low probability of appendicitis.
PurposeTo determine the likelihood of appendicitis based on symptoms, signs and laboratory test results.
ReferencesAlvarado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med. 1986 May;15(5):557-64. PubMed PMID: 3963537.

McKay R, Shepherd J. The use of the clinical scoring system by Alvarado in the decision to perform computed tomography for acute appendicitis in the ED. Am J Emerg Med. 2007 Jun;25(5):489-93. doi: 10.1016/j.ajem.2006.08.020. PubMed PMID: 17543650.
Copyright© Cambio Healthcare Systems, openEHR Foundation
AuthorsAuthor name: Syeeda S Farruque
Organisation: Cambio Healthcare Systems
Email: models@cambiocds.com
Date originally authored: 2016-12-28
Other Details LanguageAuthor name: Syeeda S Farruque
Organisation: Cambio Healthcare Systems
Email: models@cambiocds.com
Date originally authored: 2016-12-28
OtherDetails Language Independent{licence=This work is licensed under the Creative Commons Attribution-ShareAlike 3.0 License. To view a copy of this license, visit http://creativecommons.org/licenses/by-sa/3.0/., custodian_organisation=openEHR Foundation, references=Alvarado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med. 1986 May;15(5):557-64. PubMed PMID: 3963537. McKay R, Shepherd J. The use of the clinical scoring system by Alvarado in the decision to perform computed tomography for acute appendicitis in the ED. Am J Emerg Med. 2007 Jun;25(5):489-93. doi: 10.1016/j.ajem.2006.08.020. PubMed PMID: 17543650., current_contact=Heather Leslie, Atomica Informatics, original_namespace=org.openehr, original_publisher=openEHR Foundation, custodian_namespace=org.openehr, MD5-CAM-1.0.1=040354CC247D57E2E8569F37700C5478, build_uid=40c42695-658c-445d-8da8-4e3526ba3880, revision=0.0.1-alpha}
Keywordsacute appendicitis, appendicitis
Lifecyclein_development
UID0638a5d4-4012-43a5-a97d-cf379a960f99
Language useden
Citeable Identifier1051.32.875
Revision Number0.0.1-alpha
AllArchetype [runtimeNameConstraintForConceptName=null, archetypeConceptBinding=null, archetypeConceptDescription=Clinical scoring system used to determine the likelihood of appendicitis based on symptoms, signs and laboratory test results., archetypeConceptComment=null, otherContributors=Heather Leslie, Atomica Informatics, Australia, originalLanguage=en, translators=
  • Swedish: Dennis Forslund, Cambio Healthcare Systems

  • , subjectOfData=unconstrained, archetypeTranslationTree=null, topLevelToAshis={state=[], content=[], capabilities=[], relationships=[], activities=[], events=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002], code=at0002, itemType=EVENT, level=2, text=Any event, description=Default, unspecified point in time or interval event which may be explicitly defined in a template or at run-time., comment=null, uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=EVENT, bindings=null, values=null, extendedValues=null]], contacts=[], description=[], target=[], context=[], identities=[], protocol=[ResourceSimplifiedHierarchyItem [path=/protocol[at0030]/items[at0031], code=at0031, itemType=SLOT, level=2, text=Extension, description=Additional information required to capture local content or to align with other reference models/formalisms., comment=For example: local information requirements or additional metadata to align with FHIR or CIMI equivalents., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
    All not explicitly excluded archetypes, extendedValues=null]], other_participations=[], items=[], details=[], provider=[], source=[], ism_transition=[], data=[ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0004], code=at0004, itemType=ELEMENT, level=4, text=Right lower quadrant tenderness?, description=Score 2 if positive., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: No [*]
    2: Yes [*]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0005], code=at0005, itemType=ELEMENT, level=4, text=Elevated temperature (>37.3°C or 99.1°F)?, description=Score 1 if positive., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: No [*]
    1: Yes [*]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0006], code=at0006, itemType=ELEMENT, level=4, text=Rebound tenderness?, description=Score 1 if positive., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: No [*]
    1: Yes [*]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0007], code=at0007, itemType=ELEMENT, level=4, text=Migration of pain to the right lower quadrant?, description=Score 1 if positive., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: No [*]
    1: Yes [*]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0008], code=at0008, itemType=ELEMENT, level=4, text=Anorexia?, description=Score 1 if positive., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: No [*]
    1: Yes [*]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0009], code=at0009, itemType=ELEMENT, level=4, text=Nausea or vomiting?, description=Score 1 if positive., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: No [*]
    1: Yes [*]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0010], code=at0010, itemType=ELEMENT, level=4, text=Leukocytosis > 10,000?, description=Score 2 if positive., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: No [*]
    2: Yes [*]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0011], code=at0011, itemType=ELEMENT, level=4, text=Leukocyte left shift, description=Score 1 if positive., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=C_DV_ORDINAL, bindings=null, values=0: No [*]
    1: Yes [*]
    , extendedValues=null], ResourceSimplifiedHierarchyItem [path=/data[at0001]/events[at0002]/data[at0003]/items[at0012], code=at0012, itemType=ELEMENT, level=4, text=Total score, description=The sum of each ordinal score recorded for each of the eight component responses., comment=null, uncommonOntologyItems=null, occurencesFormal=0..1, occurencesText=Optional, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=DV_COUNT, bindings=null, values=min: >=0; max: <=10

    , extendedValues=null]], credentials=[]}, topLevelItems={protocol=ResourceSimplifiedHierarchyItem [path=ROOT_/protocol[at0030], code=at0030, itemType=ITEM_TREE, level=0, text=null, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=0..1, cardinalityText=optional, subCardinalityFormal=0..*, subCardinalityText=Minimum of 0 items, dataType=ITEM_TREE, bindings=null, values=null, extendedValues=null], data=ResourceSimplifiedHierarchyItem [path=ROOT_/data[at0001]/events[at0002]/data[at0003], code=at0003, itemType=ITEM_TREE, level=2, text=null, description=null, comment=null, uncommonOntologyItems=null, occurencesFormal=1..1, occurencesText=Mandatory, cardinalityFormal=0..1, cardinalityText=optional, subCardinalityFormal=0..*, subCardinalityText=Minimum of 0 items, dataType=ITEM_TREE, bindings=null, values=null, extendedValues=null]}, addHierarchyItemsTo=protocol, currentHierarchyItemsForAdding=[ResourceSimplifiedHierarchyItem [path=/protocol[at0030]/items[at0031], code=at0031, itemType=SLOT, level=2, text=Extension, description=Additional information required to capture local content or to align with other reference models/formalisms., comment=For example: local information requirements or additional metadata to align with FHIR or CIMI equivalents., uncommonOntologyItems=null, occurencesFormal=0..*, occurencesText=Optional, repeating, cardinalityFormal=null, cardinalityText=null, subCardinalityFormal=null, subCardinalityText=null, dataType=CLUSTER, bindings=null, values=Include:
    All not explicitly excluded archetypes, extendedValues=null]], minIndents={}, termBindingRetrievalErrorMessage=null]