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Point-of-Care Guides

Clinical Scoring Systems for Adults With Acute Appendicitis

Natasha Pyzocha, DO

American Family Physician. 2026;113(6):591-592.

Author disclosure: No relevant financial relationships.

This clinical content conforms to AAFP criteria for CME.

NATASHA PYZOCHA, DO, Oscar Medical Group, New York, New York; AFP Contributing Editor

Address correspondence to Natasha Pyzocha, DO, at natashapyzocha@gmail.com.

Author disclosure: No relevant financial relationships.

  1. 1.Favara G, Maugeri A, Barchitta M, et al. Comparison of RIPASA and ALVARADO scores for risk assessment of acute appendicitis: a systematic review and meta-analysis. PLoS One. 2022;17(9):e0275427.
  2. 2.Alvarez-Lozada LA, Fernandez-Reyes BA, Arrambide-Garza FJ, et al. Clinical scores for acute appendicitis in adults: a systematic review and meta-analysis of diagnostic accuracy studies. Am J Surg. 2025;240:116123.
  3. 3.Alvarado A. A practical score for the early diagnosis of acute appendicitis. Ann Emerg Med. 1986;15(5):557-564.
  4. 4.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;25(5):489-493.
  5. 5.Chong CF, Adi MIW, Thien A, et al. Development of the RIPASA score: a new appendicitis scoring system for the diagnosis of acute appendicitis. Singapore Med J. 2010;51(3):220-225.

This guide is one in a series that offers evidence-based tools to assist family physicians in improving their decision-making at the point of care.

This series is coordinated by Mark H. Ebell, MD, MS, deputy editor for evidence-based medicine.

A collection of Point-of-Care Guides published in AFP is available at https://www.aafp.org/afp/poc.

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