A quick evaluation is required for patients with acute abdominal pain. It is crucial to differentiate between surgical and nonsurgical pathology. Practical and accurate tests are essential in this differentiation. Lately, D-dimer level is found to be an important adjuvant in this diagnosis and obviously outperforms leukocyte count, which is widely used for diagnosis of certain cases [1,2]. Here, we handle this problem in a statistical perspective and combine the information from leukocyte count along with D-dimer level to increase the diagnostic accuracy of nontraumatic acute abdomen. For this purpose, various statistical learning algorithms are considered and model performances are assessed using several measures. Our results revealed that naïve Bayes, robust quadratic discriminant analysis, bagged and boosted support vector machines, single and bagged k-nearest neighbors provide an increase in diagnostic accuracies up to 8.93% and 17.86%, compared with D- dimer level and leukocyte count, respectively. Highest accuracy was obtained as 78.57% with naïve Bayes algorithm. Here, we developed a user-friendly web-tool to assist physicians in their decisions to differentially diagnose of patients with acute abdomen [3].
(†) D-dimer assay: MDA® D-dimer, bioMérieux, Durham, North Carolina, USA, normal value > 0.6 μg fibrinogen equivalent units (FEU)/ml.
(*) H.Y. Akyildiz, E. Sozuer, A. Akcan, C. Kucuk, T. Artis, I. Biri, N. Yilmaz, The value of D-dimer test in the diagnosis of patients with nontraumatic acute abdomen, Turkish Journal of Trauma & Emergency Surgery 16 (1). (2010) 22-26.
In order to use this application,
(i) enter your data which includes leukocyte count and D-dimer level of the patient using Analyze tab. Notice that the D-dimer assay method is MDA®, the unit of D-dimer level is 'µg FEU/ml' (e.g. 8.09) and the unit of leukocyte is count (e.g. 33000).
(ii) check the results (immediate laparotomy needed or not needed) in the same tab for each statistical learning and single diagnostic tests.
Please note that DDNAA tool is developed as a decision support based on [1,2] and the results may not always be correct.
Hacettepe University Faculty of Medicine Department of Biostatistics
gokmen.zararsiz@hacettepe.edu.tr
Hacettepe University Faculty of Medicine Department of Biostatistics
dincer.goksuluk@hacettepe.edu.tr
Hacettepe University Faculty of Medicine Department of Biostatistics
selcuk.korkmaz@hacettepe.edu.tr
Erciyes University Faculty of Medicine Department of Biostatistics
Erciyes University Faculty of Medicine Department of General Surgery
(1) DDNAA web-tool has been released.
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Zararsiz G, Goksuluk D, Korkmaz S, Ozturk A, Akyildiz HY (2016) "Statistical learning approaches in diagnosing patients with nontraumatic acute abdomen" Turkish Journal of Electrical Engineer and Computer Science 24, 3685-3697