To the Editor The use of a noninferiority design in the Appendicitis Acuta (APPAC) trial allowed for the assessment of primary outcomes specific to each treatment.1 However, we believe that the chosen outcomes were not equally patient-centric, leading to the erroneous conclusion that antibiotics did not meet the prespecified criterion for noninferiority compared with appendectomy.1
Minneci PC, Deans KJ. Treatment of Uncomplicated Acute Appendicitis. JAMA. 2015;314(13):1401–1402. doi:https://doi.org/10.1001/jama.2015.11426
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