***UPDATE 12/22/2014. The survey referenced in the original blog post is now closed to responses as we work on developing our study. If you are interested in staying up-to-date on this and other research developments within CERTAIN, sign up for our quarterly newsletter.***
Tennis superstar Rafael Nadal recently tried a course of antibiotics rather than having an appendectomy for appendicitis. For the past 100 years, appendectomy, or surgical removal of one’s appendix, has been the primary treatment for appendicitis. Emerging scientific evidence from Europe is challenging the notion that appendectomy is better than treating patients with antibiotics alone. The idea for this came from success treating appendicitis on submarines when access to an operating room was not possible. There have now been 5 randomized trials involving over 1000 patients and the results have been favorable for antibiotics.
Given these studies, American surgeons are starting to ask, “Is it time to change our approach to treating appendicitis?” To figure this out, we need your help.
We are developing a US randomized trial to determine if treatment with antibiotics is as effective as appendectomy, when judged by patients. In randomized studies, a person has a 50% chance (flip of a coin) of being in either treatment arm. For our proposed study, patients would be randomized to 1 of 2 treatment options – Appendectomy or Antibiotics. For this to work, patients need to be willing to participate in the study, and given people’s knowledge and opinions about treatment for appendicitis, we are asking people like you to help us get a sense of willingness to participate if you had appendicitis.
Sometimes a lack of willingness to participate in research is due to a perception that the risks or burdens of participation outweigh the benefit. Here’s what we know about these 2 treatment options. For most people having an appendectomy, the operation lasts 1-2 hours and people return home the next day and are able to resume normal activities within several days. After a follow-up appointment with their surgeon shortly after the procedure, people go back to normal life. Surgical procedures are not without risk. Most patients will experience nausea, discomfort or pain from the incisions. In some cases, patients may experience prolonged hospital stays and infections at the site of incision.
Antibiotics only approaches require patients to be admitted to the hospital and receive 24-48 hours of intravenous (IV) antibiotics. Once symptoms improve, patients return home and continue taking antibiotics for one week. Under the best circumstances, patients will not experience further symptoms again and not require treatment or surgery. Antibiotics alone are not without risks. Patients may experience side effects from antibiotics and prolonged pain or discomfort from symptoms associated with appendicitis. There is also a chance that an individual will develop appendicitis in the future and eventually need surgery within 48 hrs (12-47%)or sometime after (9-35%).
Given what we’ve told you, if you had appendicitis, would you be willing to join a study that would randomize you (a 50% chance, or flip of a coin) to “surgery ” or “antibiotics?” Please click here to take our one-question survey.
Would you like to be a patient advisor for this research project? If so, please contact Sarah Lawrence at firstname.lastname@example.org or (206) 221-7453.
Photo credit: si.com