Antibiotics versus Appendectomy for Appendicitis

Overview

Featured Article

CODA Collaborative, Flum DR, Davidson GH, et al. A Randomized Trial Comparing Antibiotics with Appendectomy for Appendicitis. N Engl J Med. 2020;383(20):1907-1919. doi:10.1056/NEJMoa2014320

Expert Reviews

Methodological Reviewer: Anand Govindarajan MD, MSc, FRCSC, University of Toronto

Clinical Reviewer: Kelly Vogt MD, MSc, FRCSC, Western University

 

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Questions

Please read the above articles and be prepared to discuss the following:

  1. What is the clinical question being addressed?
  2. Was the assignment of patients to treatment randomized and concealed?
  3. Were all patients who entered the trial properly accounted for and attributed for at is conclusion?
  4. Were patients, their clinicians and study personnel “blind” to treatment?
  5. Did novel and standard treatment groups start with the same prognosis?
  6. Was the effect of the standard treatment preserved?
  7. Did the investigators analyze patients according to the treatment they received, as well as to the groups to which they were assigned?
  8. How large and precise was the treatment effect?
  9. Can the results be applied to my patient care?
  10. Were all patient-important outcomes considered?
  11. Are the likely treatment benefits worth the potential harm and costs?
  12. State the conclusion. Have the authors addressed the clinical question posed?
  13. Does the evidence support the conclusion?