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Table 4 Scientific agreement of formulated recommendations for acute pancreatitis diagnosis in the included guidelines (2014–2020)

From: Appraisal of the diagnostic procedures of acute pancreatitis in the guidelines

Guideline

Reference standard

Ar [2]

Li [3]

Jo [4]

Ma [5]

AI [6]

GS [7]

PD [8]

(1) Primary diagnosis of AP

Symptoms and signs

Abdominal pain (acute onset of a persistent, severe, epigastric pain often radiating to the back)

80–100%

80–100%

80–100%

Biochemical evidence

Serum lipase activity (or amylase) at least 3 times greater than the upper limit of normal

80–100%

80–100%

80–100%

80–100%

80–100%

Characteristic findings from abdominal imaging

Characteristic findings of acute pancreatitis on ultrasound, computed tomography or magnetic resonance imaging

80–100%

80–100%

80–100%

80–100%

80–100%

(2) Classification of the severity of AP

Classification tools

Revised Atlanta Classification

80–100%

80–100%

80–100%

80–100%

C-reactive Protein(CRP) level ≥ 150 mg/l

40–60%

80–100%

80–100%

APACHE-II score

80–100%

80–100%

80–100%

80–100%

(3) Etiological diagnosis of AP

 

Ultrasound (US) / endoscopic ultrasound (EUS)

80–100%

80–100%

80–100%

20–40%

40–60%

80–100%

 

Magnetic resonance imaging (MRI) / Magnetic resonance cholangiopancreatography (MRCP)

80–100%

80–100%

80–100%

80–100%

80–100%

 

Endoscopic retrograde cholangiopancreatography (ERCP)

80–100%

80–100%

80–100%

80–100%

(4) Diagnosis of comorbidities of AP

pancreatic necrosis/ abdominal fluid collection/pseudocyst / walled-off necrosis (WoN)

CE-CT

80–100%

40–60%

80–100%

80–100%

80–100%

80–100%

Infected collection, necrosis or WoN

Fine needle aspiration (FNA)

80–100%

80–100%

80–100%

80–100%

80–100%

20–40%

  1. Measurement Scale of Rate of Agreement: 0–20%: radically different; 20–40%: numerous major scientific disagreements present; 40–60%: few major scientific disagreements present; 60–80%: only minor scientific disagreements present; 80–100%: absolute scientific agreement. In blank fields, no information is available
  2. APACHE-II score Acute Physiology and Chronic Health Evaluation II score; CECT Contrast-enhanced computed tomography