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Perception of Treatment Success and Impact on Function with Antibiotics or Appendectomy for Appendicitis: A Randomized Clinical Trial with an Observational Cohort
To compare secondary patient reported outcomes of perceptions of treatment success and function for patients treated for appendicitis with appendectomy vs. antibiotics at 30 days. SUMMARY BACKGROUND DATA: The Comparison of Outcomes of antibiotic Drugs and Appendectomy trial found antibiotics noninfe...
Autores principales: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Lippincott Williams & Wilkins
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10174100/ https://www.ncbi.nlm.nih.gov/pubmed/35815898 http://dx.doi.org/10.1097/SLA.0000000000005458 |
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author | Thompson, Callie M. Voldal, Emily C. Davidson, Giana H. Sanchez, Sabrina E. Ayoung-Chee, Patricia Victory, Jesse Guiden, Mary Bizzell, Bonnie Glaser, Jacob Hults, Christopher Price, Thea P. Siparsky, Nicole Ohe, Kristin Mandell, Katherine A. DeUgarte, Daniel A. Kaji, Amy H. Uribe, Lisandra Kao, Lillian S. Mueck, Krislynn M. Farjah, Farhood Self, Wesley H. Clark, Sunday Drake, F. Thurston Fischkoff, Katherine Minko, Elizaveta Cuschieri, Joseph Faine, Brett Skeete, Dionne A. Dhanani, Naila Liang, Mike K. Krishnadasan, Anusha Talan, David A. Fannon, Erin Kessler, Larry G. Comstock, Bryan A. Heagerty, Patrick J. Monsell, Sarah E. Lawrence, Sarah O. Flum, David R. Lavallee, Danielle C. |
author_facet | Thompson, Callie M. Voldal, Emily C. Davidson, Giana H. Sanchez, Sabrina E. Ayoung-Chee, Patricia Victory, Jesse Guiden, Mary Bizzell, Bonnie Glaser, Jacob Hults, Christopher Price, Thea P. Siparsky, Nicole Ohe, Kristin Mandell, Katherine A. DeUgarte, Daniel A. Kaji, Amy H. Uribe, Lisandra Kao, Lillian S. Mueck, Krislynn M. Farjah, Farhood Self, Wesley H. Clark, Sunday Drake, F. Thurston Fischkoff, Katherine Minko, Elizaveta Cuschieri, Joseph Faine, Brett Skeete, Dionne A. Dhanani, Naila Liang, Mike K. Krishnadasan, Anusha Talan, David A. Fannon, Erin Kessler, Larry G. Comstock, Bryan A. Heagerty, Patrick J. Monsell, Sarah E. Lawrence, Sarah O. Flum, David R. Lavallee, Danielle C. |
author_sort | Thompson, Callie M. |
collection | PubMed |
description | To compare secondary patient reported outcomes of perceptions of treatment success and function for patients treated for appendicitis with appendectomy vs. antibiotics at 30 days. SUMMARY BACKGROUND DATA: The Comparison of Outcomes of antibiotic Drugs and Appendectomy trial found antibiotics noninferior to appendectomy based on 30-day health status. To address questions about outcomes among participants with lower socioeconomic status, we explored the relationship of sociodemographic and clinical factors and outcomes. METHODS: We focused on 4 patient reported outcomes at 30 days: high decisional regret, dissatisfaction with treatment, problems performing usual activities, and missing >10 days of work. The randomized (RCT) and observational cohorts were pooled for exploration of baseline factors. The RCT cohort alone was used for comparison of treatments. Logistic regression was used to assess associations. RESULTS: The pooled cohort contained 2062 participants; 1552 from the RCT. Overall, regret and dissatisfaction were low whereas problems with usual activities and prolonged missed work occurred more frequently. In the RCT, those assigned to antibiotics had more regret (Odd ratios (OR) 2.97, 95% Confidence intervals (CI) 2.05–4.31) and dissatisfaction (OR 1.98, 95%CI 1.25–3.12), and reported less missed work (OR 0.39, 95%CI 0.27–0.56). Factors associated with function outcomes included sociodemographic and clinical variables for both treatment arms. Fewer factors were associated with dissatisfaction and regret. CONCLUSIONS: Overall, participants reported high satisfaction, low regret, and were frequently able to resume usual activities and return to work. When comparing treatments for appendicitis, no single measure defines success or failure for all people. The reported data may inform discussions regarding the most appropriate treatment for individuals. TRIAL REGISTRATION: Clinicaltrials.gov Identifier: NCT02800785. |
format | Online Article Text |
id | pubmed-10174100 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | Lippincott Williams & Wilkins |
record_format | MEDLINE/PubMed |
spelling | pubmed-101741002023-05-12 Perception of Treatment Success and Impact on Function with Antibiotics or Appendectomy for Appendicitis: A Randomized Clinical Trial with an Observational Cohort Thompson, Callie M. Voldal, Emily C. Davidson, Giana H. Sanchez, Sabrina E. Ayoung-Chee, Patricia Victory, Jesse Guiden, Mary Bizzell, Bonnie Glaser, Jacob Hults, Christopher Price, Thea P. Siparsky, Nicole Ohe, Kristin Mandell, Katherine A. DeUgarte, Daniel A. Kaji, Amy H. Uribe, Lisandra Kao, Lillian S. Mueck, Krislynn M. Farjah, Farhood Self, Wesley H. Clark, Sunday Drake, F. Thurston Fischkoff, Katherine Minko, Elizaveta Cuschieri, Joseph Faine, Brett Skeete, Dionne A. Dhanani, Naila Liang, Mike K. Krishnadasan, Anusha Talan, David A. Fannon, Erin Kessler, Larry G. Comstock, Bryan A. Heagerty, Patrick J. Monsell, Sarah E. Lawrence, Sarah O. Flum, David R. Lavallee, Danielle C. Ann Surg Randomized Controlled Trial To compare secondary patient reported outcomes of perceptions of treatment success and function for patients treated for appendicitis with appendectomy vs. antibiotics at 30 days. SUMMARY BACKGROUND DATA: The Comparison of Outcomes of antibiotic Drugs and Appendectomy trial found antibiotics noninferior to appendectomy based on 30-day health status. To address questions about outcomes among participants with lower socioeconomic status, we explored the relationship of sociodemographic and clinical factors and outcomes. METHODS: We focused on 4 patient reported outcomes at 30 days: high decisional regret, dissatisfaction with treatment, problems performing usual activities, and missing >10 days of work. The randomized (RCT) and observational cohorts were pooled for exploration of baseline factors. The RCT cohort alone was used for comparison of treatments. Logistic regression was used to assess associations. RESULTS: The pooled cohort contained 2062 participants; 1552 from the RCT. Overall, regret and dissatisfaction were low whereas problems with usual activities and prolonged missed work occurred more frequently. In the RCT, those assigned to antibiotics had more regret (Odd ratios (OR) 2.97, 95% Confidence intervals (CI) 2.05–4.31) and dissatisfaction (OR 1.98, 95%CI 1.25–3.12), and reported less missed work (OR 0.39, 95%CI 0.27–0.56). Factors associated with function outcomes included sociodemographic and clinical variables for both treatment arms. Fewer factors were associated with dissatisfaction and regret. CONCLUSIONS: Overall, participants reported high satisfaction, low regret, and were frequently able to resume usual activities and return to work. When comparing treatments for appendicitis, no single measure defines success or failure for all people. The reported data may inform discussions regarding the most appropriate treatment for individuals. TRIAL REGISTRATION: Clinicaltrials.gov Identifier: NCT02800785. Lippincott Williams & Wilkins 2023-06 2022-07-11 /pmc/articles/PMC10174100/ /pubmed/35815898 http://dx.doi.org/10.1097/SLA.0000000000005458 Text en Copyright © 2022 The Author(s). Published by Wolters Kluwer Health, Inc. https://creativecommons.org/licenses/by-nc-nd/4.0/This is an open access article distributed under the terms of the Creative Commons Attribution-Non Commercial-No Derivatives License 4.0 (https://creativecommons.org/licenses/by-nc-nd/4.0/) (CCBY-NC-ND), where it is permissible to download and share the work provided it is properly cited. The work cannot be changed in any way or used commercially without permission from the journal. http://creativecommons.org/licenses/by-nc-nd/4.0/ (https://creativecommons.org/licenses/by-nc-nd/4.0/) |
spellingShingle | Randomized Controlled Trial Thompson, Callie M. Voldal, Emily C. Davidson, Giana H. Sanchez, Sabrina E. Ayoung-Chee, Patricia Victory, Jesse Guiden, Mary Bizzell, Bonnie Glaser, Jacob Hults, Christopher Price, Thea P. Siparsky, Nicole Ohe, Kristin Mandell, Katherine A. DeUgarte, Daniel A. Kaji, Amy H. Uribe, Lisandra Kao, Lillian S. Mueck, Krislynn M. Farjah, Farhood Self, Wesley H. Clark, Sunday Drake, F. Thurston Fischkoff, Katherine Minko, Elizaveta Cuschieri, Joseph Faine, Brett Skeete, Dionne A. Dhanani, Naila Liang, Mike K. Krishnadasan, Anusha Talan, David A. Fannon, Erin Kessler, Larry G. Comstock, Bryan A. Heagerty, Patrick J. Monsell, Sarah E. Lawrence, Sarah O. Flum, David R. Lavallee, Danielle C. Perception of Treatment Success and Impact on Function with Antibiotics or Appendectomy for Appendicitis: A Randomized Clinical Trial with an Observational Cohort |
title | Perception of Treatment Success and Impact on Function with Antibiotics or Appendectomy for Appendicitis: A Randomized Clinical Trial with an Observational Cohort |
title_full | Perception of Treatment Success and Impact on Function with Antibiotics or Appendectomy for Appendicitis: A Randomized Clinical Trial with an Observational Cohort |
title_fullStr | Perception of Treatment Success and Impact on Function with Antibiotics or Appendectomy for Appendicitis: A Randomized Clinical Trial with an Observational Cohort |
title_full_unstemmed | Perception of Treatment Success and Impact on Function with Antibiotics or Appendectomy for Appendicitis: A Randomized Clinical Trial with an Observational Cohort |
title_short | Perception of Treatment Success and Impact on Function with Antibiotics or Appendectomy for Appendicitis: A Randomized Clinical Trial with an Observational Cohort |
title_sort | perception of treatment success and impact on function with antibiotics or appendectomy for appendicitis: a randomized clinical trial with an observational cohort |
topic | Randomized Controlled Trial |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10174100/ https://www.ncbi.nlm.nih.gov/pubmed/35815898 http://dx.doi.org/10.1097/SLA.0000000000005458 |
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