If you or your child had appendicitis, would you choose surgery or antibiotics for treatment? Why?
Such is the scenario that Marc D. Basson, MD, PhD, MBA, FACS, senior associate dean for Medicine and Research at the UND School of Medicine and Health Sciences (SMHS), presented to nearly 2,000 participants in a research study published this week by the medical journal JAMA Surgery.
According to Dr. Basson (right), most patients know that the traditional treatment for appendicitis is appendectomy, or surgical removal of the appendix. And although antibiotic treatment for appendicitis is emerging as an alternative to surgery, disadvantages of antibiotic-only therapy for appendicitis—which include longer hospitalization, prolonged recovery, and a higher rate of appendicitis recurrence—mean that some surgeons resist offering patients non-surgical treatment options.
For this reason, Dr. Basson went straight to the people making this decision in an effort to gauge patient knowledge and attitudes toward the use of antibiotics for appendicitis.
“We decided to come at the question differently, asking, ‘Well, what do patients actually want and why?’” explains Dr. Basson, whose co-authors were Ross Crosby, Ph.D., vice president for research and director of biomedical statistics at the Neuropsychiatric Research Institute in Fargo, N.D., and professor in the UND SMHS Department of Psychiatry and Behavioral Science; and Alexis Hanson, a third-year medical student at UND.
As it turns out, a commanding 86 percent of the 1,728 survey participants would choose laparoscopic appendectomy (a less invasive type of surgery) for themselves and their children in such a scenario. Comparatively, 9.4 percent of respondents would choose antibiotics alone, and only 5 percent a traditional open appendectomy.
“What’s interesting is that we took a subgroup of that 86 percent surgery-first cohort and asked what their concerns were with antibiotics,” Dr. Basson continues. “We asked them ‘What would get you to change?’ We found that the failure rate of the drugs was the primary problem. But when we reset those numbers—asking their response if the antibiotic failure rate was lowered by 5 percent, 10 percent, and so on—we saw a lot more people willing to choose antibiotics over surgery.”
So Dr. Basson’s team explored not only what patients know when it comes to their treatment options, but what they value—and how their values influence their decision-making process.
“This, we believe, should set the research agenda for the future in this area. If we could come up with a new way of reducing the failure rate of antibiotics, that might result in a lot more people choosing antibiotic therapy, which would be a huge advance in the field.”
Dr. Basson’s article is available online here.
It has been a fun and exciting week—with more to come!
First, a couple of reminders about two upcoming events next week:
Happy New Year! Susan and I are just back from a wonderful week with our grandkids, and we are energized for an exciting 2018.
Susan and I wish you all season’s greetings, Merry Christmas, and best wishes in the new year. My column will resume on January 5, 2018.
As the fall semester comes to a close, I’d like to take this opportunity to thank all of you—faculty, staff, students, colleagues, community members, and legislators—for your efforts and contributions during the first half of the 2017-'18 academic year.
Dr. Joshua Wynne, UND's Vice President for Health Affairs and Dean of the School of Medicine and Health Sciences, will present his "State of the School" address at 3:30 p.
You are invited to join Dean Joshua Wynne for complimentary coffee or tea at Java with Josh from 8:30 a.
The UND Department of Wellness and Health Promotion and the UND Work Well program invite you to a Lego Social Hour to be held from 2 p.
Neville Alberto, MD FACP, hospitalist with Sanford Health and program director for the SMHS Transitional Year Residency Program in Fargo, has been invited to organize and conduct a workshop in Point of Care Ultrasound at the American College of Physicians–Central America Chapter meeting.
If you or your child had appendicitis, would you choose surgery or antibiotics for treatment? Why? Such is the scenario that Marc D.
Thirty-two University of North Dakota School of Medicine and Health Sciences (SMHS) students begin the clinical portion of their studies this week in an effort to earn their Master of Physician Assistant Studies degree.
The National Institutes of Health (NIH) has awarded Jyotika Sharma, PhD, associate professor in the Department of Biomedical Sciences at the UND School of Medicine and Health Sciences (SMHS), a major grant known as an R21.
Practice-based Research Networks (PBRNs) are networks of clinicians and practices collaborating to answer health care questions that turn research findings into practice.
n anticipation of the third year funding, the Center for Host-Pathogen Interactions at the UND School of Medicine and Health Sciences invites applications for pilot studies to support research that fits well within the scientific theme of our NIH funded Center For Biomedical Research Excellence (COBRE).
Laurel Carr is the new Brain Research Technician and Autopsy Assistant in the Department of Pathology the UND School of Medicine and Health Sciences.
Kathryn “Kat” Camburn began employment with UND as an administrative assistant for the Department of Psychiatry and Behavioral Science on the SMHS southeast campus in Fargo on November 6.
Karen Vanderzanden is a new research specialist at the Center for Rural Health (CRH) at the University of North Dakota SMHS in Grand Forks.