Author Interviews, Cost of Health Care, JAMA, Surgical Research / 07.09.2021

MedicalResearch.com Interview with: Andrew P. Loehrer, MD, MPH Assistant Professor Department of Surgery, Division of Surgical Oncology Dartmouth-Hitchcock MedicalResearch.com: What is the background for this study? Response: Patient cost sharing represents the portion of costs covered by insurance that individuals pay out of pocket, including deductibles, co-payment, and co-insurance. Cost sharing is increasingly common and also increasingly expensive for patients with commercial health insurance across the United States. While designed to increase patient responsibility for health care spending, prior work has shown that higher cost sharing is also associated with decreased use of health care overall, both needed and discretionary. However, little work has been done as to how high cost sharing may affect common and costly conditions like acute appendicitis and acute diverticulitis.  (more…)
Author Interviews, JAMA, Surgical Research / 23.02.2020

MedicalResearch.com Interview with: Paulina Salminen MD PhD Chief and Professor of surgery Turku University, Finland MedicalResearch.com: What is the background for this study? Response: Appendectomy has been the standard treatment for uncomplicated acute appendicitis and currently one of the most commonly performed surgical procedures. We now know that there are two different forms of acute appendicitis: the more common milder uncomplicated acute appendicitis and the more severe complicated acute appendicitis. While the complicated form is primarily still treated surgically, in recent years evidence from randomised trials and meta-analyses show that antibiotics are a safe and efficient treatment of uncomplicated acute appendicitis  also at long-term follow-up. Quality of life (QOL) and patient satisfaction after antibiotic therapy or appendectomy for uncomplicated acute appendicitis have been studied previously in a pediatric population but not in an adult population. Our aim was to compare long-term quality of life and patient satisfaction after antibiotic therapy and appendectomy for the treatment of uncomplicated acute appendicitis in patients enrolled in the original APPAC trial. (more…)
Author Interviews, Infections, JAMA, Surgical Research / 30.01.2018

MedicalResearch.com Interview with: Marc D. Basson, MD, PhD, MBA Professor of Surgery, Pathology, and Biomedical Science Senior Associate Dean for Medicine and Research University of North Dakota School of Medicine & Health Sciences Grand Forks, ND 58202    MedicalResearch.com: What is the background for this study? What are the main findings? Response: There are now several studies that describe the use of antibiotics without surgery to manage acute uncomplicated appendicitis. This entails a prolonged treatment course and has a substantial rate of failure and recurrence, but in patients in whom it succeeds surgery can be avoided. Many surgeons resist offering this choice because they perceive it as substandard compared to surgery, which is rapid, and when it goes well (as it usually does) has no failure or recurrence rate. Instead of debating the statistics, we decided to ask people what they would prefer if they had appendicitis and why. We found that about nine tenths of people would choose surgery, but about one tenth would choose antibiotics, with some subtle distinctions depending on the characteristics of the people we asked.  (For instance, surgeons, doctors in general, and people who knew someone who had previously had appendicitis were all a bit more likely to opt for surgery.)  Furthermore, we found that the key issue for most people was not the prolonged treatment course but the rates of failure and recurrence with antibiotics. (more…)
Author Interviews, Gastrointestinal Disease, Pediatrics / 11.02.2014

Jim Tsung, MD, MPH Department of Emergency Medicine Mount Sinai School of Medicine Guggenheim Pavilion 1 Gustave Levy Place Box 1149 New York, NY 10029MedicalResearch.com Interview with: Jim Tsung, MD, MPH Department of Emergency Medicine Mount Sinai School of Medicine Guggenheim Pavilion New York, NY 10029 MedicalResearch.com: What are the main findings of the study? Dr. Tsung: 1.  Point-of-care ultrasound performed by clinicians was as accurate as ultrasound performed in the radiology department for evaluating appendicitis in children. 2.  This led to significant reductions in emergency department stays when point-of-care ultrasound was able to contribute to the decision to send the patient to the operating room or to discharge home without further imaging studies. On average, a 2 hour (46%) reduction in ED LOS for patients only requiring radiology ultrasound and a 6 hour (68%) reduction in ED LOS for patients that needed CT scan. 3.  Point-of-care ultrasound can also reduce the rate of CT scans obtained when used as a front-line test, 44% to 27%. (more…)