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CONservative TReatment of Appendicitis in Children: a randomised controlled feasibility Trial (CONTRACT) , Hall, Crawley et al, 2021

Discussion in 'Health News and Research unrelated to ME/CFS' started by Andy, Feb 21, 2021.

  1. Andy

    Andy Committee Member & Outreach

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    Open access, https://adc.bmj.com/content/early/2021/01/12/archdischild-2020-320746
     
    MSEsperanza, Barry, Snowdrop and 2 others like this.
  2. Cheshire

    Cheshire Moderator Staff Member

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    Is she at least leaving the CFS field?

    (Still enjoying acronyms, though...)
     
  3. Adrian

    Adrian Administrator Staff Member

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    I wonder if she is still trying to play tricks with the ethics committees in doing a feasibility study that will suddenly become a full study
     
  4. Hutan

    Hutan Moderator Staff Member

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    She may be playing tricks, but with 'more participants having perforated appendicitis than anticipated', I expect this feasibility trial will be put to one side and there will be another roll of the dice for the main trial.

    Cheaper for the health system/insurers than an operation no doubt, but at least the children in the study get antibiotics and monitoring - rather than thinking happy thoughts about healthy appendices and an investigation of what past trauma or personality failing has caused the problem.

    I suppose a pandemic is a perfect time to investigate non-operative alternatives to surgeries - as people have a good incentive to not go into hospital. Possibly it won't be so easy to recruit with everyone vaccinated.
     
  5. Snowdrop

    Snowdrop Senior Member (Voting Rights)

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    Question for anyone who knows: Is there no obligation to say where the funding comes from for a study?
     
  6. Mithriel

    Mithriel Senior Member (Voting Rights)

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    I am shocked speechless. Perforated appendicitis is no joke. My Mother in Law died at age 75 due to adhesions on the bowel caused by a perforated appendix operation when she was 7 causing torsion and tissue death.

    It tells you the quality of the doctor when they publish results that are said to be "be safe and adverse event profiles acceptable" despite the number of perforated appendicitis being higher than anticipated.

    It is proof that this is not patient centred research.
     
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  7. Amw66

    Amw66 Senior Member (Voting Rights)

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    Perhaps of interest as the appendix functions as part of the immune system ( and is not something left over from its fetal role)
     
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  8. Milo

    Milo Senior Member (Voting Rights)

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    Right, the study is feasible, but more patients risk death as a side effect of not getting the surgery. Will parents be informed of that?
     
  9. MSEsperanza

    MSEsperanza Senior Member (Voting Rights)

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    I'm afraid she's just showing that children's wellbeing is not what she primarily cares for also in other illnesses than ME.
    Are their beliefs good reasons why not to wait for the results of these other studies first?

    But look how generous they are:

    Discharge assessment and follow-up
     
    Last edited: Feb 22, 2021
  10. MSEsperanza

    MSEsperanza Senior Member (Voting Rights)

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    It's in the footnotes:

    Funding
     
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  11. Trish

    Trish Moderator Staff Member

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    I did a quick google search and found this paper from April 2020:
    Diagnosis and treatment of acute appendicitis: 2020 update of the WSES Jerusalem guidelines
    https://wjes.biomedcentral.com/articles/10.1186/s13017-020-00306-3
    which has a section on treatment with antibiotics in non complicated acute appendicitis, including in children. It's not a new idea, and seems to be recommended in some cases.
     
  12. Aslaug

    Aslaug Moderator Staff Member

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    Recently there was a short debate in "Dagens Medisin" (a health journal in Norway) about antibiotic treatment vs an operation for appendicitis. One proponent started it and got a reply from a surgeon. I'm pretty sure that was about adult patients, though.
     

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