A Comparison of the Modified Alvarado Score and the Raja Isteri Pengiran Anak Saleha Appendicitis (Ripasa) Score in a Southeast Asian Population With Histopathology as the Gold Standard

Background The diagnosis of acute appendicitis has remained difficult despite it being one of the most common surgical emergencies in the world. One of the most frequently used scoring systems is the Modified Alvarado Score (MAS). However, the MAS has been known to be less efficient in Asian populations. To overcome this issue, the Raja Isteri Pengiran Anak Saleha Appendicitis (RIPASA) score has been specifically developed to improve the diagnosis of acute appendicitis in Asian populations. This study aimed to evaluate the accuracy of the RIPASA score compared to the MAS for the diagnosis of acute appendicitis in a Southeast Asian population keeping histopathology as the gold standard. Methodology The study group comprised 150 patients. Data were collected from each patient using a simple proforma to ascertain both the MAS and the RIPASA score for each patient at the time of presentation. The patients then underwent open appendectomy and histopathology was used as the gold standard to determine the presence or absence of acute appendicitis in the excised specimens. Results The RIPASA score had a sensitivity and specificity of 89.83% and 59.38%, respectively, compared to 64.41% and 53.12%, respectively, for the MAS. Diagnostic accuracy was similarly higher for the RIPASA score at 83.33% versus 62.00% for the MAS. Conclusions The RIPASA score is superior to the MAS for the diagnosis of acute appendicitis. Using the RIPASA score instead of the MAS in Southeast Asian populations can lead to a more accurate and timely clinical diagnosis of patients with suspected acute appendicitis and help improve patient outcomes.

Entrepreneurial leadership: the key to develop creativity in organizations

Purpose

Entrepreneurial leadership has been developed from the existing leadership and entrepreneurship literature as a new leadership theory to meet the dynamic changes in the 21st century. Accordingly, the main purpose of this study is to investigate the effect of entrepreneurial leadership on employee creativity and the mediating influence of psychological empowerment and psychological safety, with the lens of social learning theory.

Design/methodology/approach

Data were collected from the manufacturing sector of Pakistan with a sample size of 280 dyads of managers and employees. A two-step analytical strategy was adopted through which the measurement model was validated by using confirmatory factor analysis and structural equation modeling to estimate the structural model to fit the data. The bootstrapping method was applied for testing the mediation analysis.

Findings

The current study found that entrepreneurial leadership positively related to employee creativity. Moreover, it was found that psychological empowerment and psychological safety mediated the relationships between entrepreneurial leadership and employee creativity.

Research limitations/implications

The findings of the current study provide guidance to managers and businessmen on how to develop the creative skills of employees by adopting entrepreneurial leadership behaviors. Besides, this study enriches the literature by exploring the performance mechanism of entrepreneurial leadership to develop employee creativity.

Originality/value

The current study is considered the first to examine the role of entrepreneurial leaders in stimulating employee creativity through psychological safety and psychological empowerment. As such, it enriches the creativity literature by exploring the employee creativity mechanism through entrepreneurial leadership and validating the importance of psychological factors in the development of creativity compared to previous studies, which have focused primarily on the concept or scale development of entrepreneurial leadership. Furthermore, it provides several theoretical and managerial implications along with future opportunities.