Society of University SurgeonsImpact of a randomized clinical trial on children with perforated appendicitis
Section snippets
Methods
To determine the impact that the timing of appendectomy clinical trial had on our practice patterns, data were collected on patients for the 18 months immediately preceding (April 2005–September 2006) and after the completion of the trial (September 2009–March 2011). Patients with a discharge diagnosis of perforated appendicitis who were younger than 18 years of age were identified by querying the surgical practice database for the International Classification of Diseases, 9th edition code for
Patient demographics
Ninety-two patients were diagnosed with perforated appendicitis during the 18 months before the trial. The posttrial patients consisted of 103 patients with a diagnosis of perforated appendicitis during the 18 months after the trial. Diagnosis during both time periods was based on history, physical examination, laboratory values, and imaging. There was no difference in age, sex, or race between the two time periods (Table I). There were more self-pay patients in the pretrial group (P = .002),
Discussion
Evidence-based medicine has been defined as “the conscientious, explicit and judicious use of current best evidence in making decisions about the care of individual patients.”9 This approach has been increasingly used in the past two decades to direct patient care, and there has been a parallel increase in clinical trials amongst multiple specialties. Decision-making based on the best evidence can lead to improved quality of patient care and better patient outcomes if the results of the trials
References (18)
- et al.
Hospital cost analysis of a prospective, randomized trial of early vs interval appendectomy for perforated appendicitis in children
J Am Coll Surg
(2012) - et al.
Translation of clinic trial results into practice: temporal patterns of beta-blocker utilization for heart failure at hospital discharge and during ambulatory follow-up
Am Heart J
(2007) - et al.
National estimates of hospital utilization by children with gastrointestinal disorders: analysis of the 1997 kids' inpatient database
J Pediatr
(2004) - et al.
Current practice patterns in the treatment of perforated appendicitis in children
J Am Coll Surg
(2003) - et al.
Initial laparoscopic appendectomy versus initial nonoperative management and interval appendectomy for perforated appendicitis with abscess: a prospective, randomized trial
J Pediatr Surg
(2010) - et al.
Complicated appendicitis in children: is laparoscopic appendectomy appropriate? A comparative study with the open appendectomy—our experience
J Pediatr Surg
(2009) - et al.
Antibiotics and appendicitis in the pediatric population: an American Pediatric Surgical Association Outcomes and Clinical Trials Committee systematic review
J Pediatr Surg
(2010) - et al.
Adherence of randomized trials within children's surgical specialties published during 2000 to 2009 to standard reporting guidelines
J Am Coll Surg
(2013) - et al.
Managing clinical knowledge for health care improvement
Yearb Med Inform
(2000)
Cited by (3)
Creating diagnostic criteria for perforated appendicitis using cross-sectional imaging
2017, Pediatric Surgery International