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From the JAMA Network
February 23, 2016

Shared Decision Making in Uncomplicated Appendicitis: It Is Time to Include Nonoperative Management

Author Affiliations
  • 1Division of Bariatric, Foregut, and Advanced Gastrointestinal Surgery, Department of Surgery, Stony Brook University Medical Center, Stony Brook, New York
JAMA. 2016;315(8):811-812. doi:10.1001/jama.2016.0168

In December 2015, JAMA Surgery published the results of a prospective cohort study by Minneci and colleagues1 assessing the effectiveness of shared decision making for nonoperative management of 102 patients (median age, 12 years; range, 7-17 years) with uncomplicated acute appendicitis. At 1 year, nonoperative management (chosen by 37 patients/families) was successful, as defined by no intervention at 1 year in 28 children (75%), and was associated with fewer disability days and lower appendicitis-related health care costs compared with children who underwent an operation (chosen by 65 patients/families). These findings corroborate a shorter-term nonrandomized clinical trial of the feasibility of nonoperative management for 30 children with uncomplicated appendicitis that had similar results.2 This study demonstrated nonoperative management was associated with fewer disability days, quicker return to school, and higher quality-of-life scores for both children and their parents at 30 days after surgery.2

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