Skip to main content

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