@alexlewis @sabicool I think weâve had this discussion before, but I do think this card is misleading in the context of Australian guidelines. Although I guess it could be argued it may be the best investigation to diagnose, I honestly am yet to see a case where it is used, so I would probably err on the side of not keeping this card in for sake of creating confusion. But happy to hear other thoughts on this.
Might also include @braviboron and @mrvhyte in this discussion for some other thoughts too. See [03.05.2025] New Note, Malleus Clinical Medicine (AU/NZ)/Stapedius, ID 673218 for more context on earlier discussions.
Perhaps best to reword to âWhat is the most accurate testâ or âWhat is the most specific and sensitive test âŚâ? It would be reasonable to use UpToDate as a source in that case, in my opinion.
@Stapedius Would an acceptable reframing be âwhat investigation for appendicitis has the highest sensitivity/specificity?â. With the already included addendum that often is not required, nor is it standard practice.
I think framing it as âmost accurateâ as braviboron said is a bit cleaner then âmost sensitive/specificâ. I do think we need to use an Australian source for all management/investigation cards incl this card. Would be good in the extra field to include âas per ultrasound is used xyz and CT is used if xyzâ
Edit: happy to use up-to-date for sourcing of âfactsâ like CT is the most accurate, but think any investigation/management card is better if itâs in the context of Australian guidelines.
E.g. if the Australian guidelines says âuse US for pregnant women and CT when the US is not conclusive or somethingâ without providing reasoning I think the best card would source up-to-date for the âCT is most accurateâ and then source an Australian guidelines for context provided in the extra field.
This sounds reasonable to me and agree with the above discussions around facts to do with the sensitivity/specificity of a test vs actual clinical practice. Happy to approve in this case. 