Letter to the Editor
Response to Diagnosis of Appendicitis
Abstract
The article by Mathis et al1 in SMJ in December 2005 reports 150 cases seen by emergency department physicians with a “discharge diagnosis of appendicitis.” Flaws in their study serve to negate the conclusions drawn. They acknowledge that the retrospective study had a bias associated with a higher complication rate occurring when the NCT (no CT) patients were taken to surgery sooner than those having a CT that were less ill. The study also failed to specify if a surgeon was involved in the decision to order a CT scan. Furthermore, they commented upon the “inherent limitations” of their study when relying on chart documentation. The ordering of in-house radiological tests by hospital-affiliated attending physicians, such as in the ER, is a further unnoted bias consideration.This content is limited to qualifying members.
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