In Reply We thank our colleagues for their interest in our study. We fully agree with Minneci and Deans regarding advocating shared decision-making and more patient-centric outcomes. However, the Appendicectomy Versus Antibiotics in the Treatment of Acute Uncomplicated Appendicitis (APPAC) trial was designed as a randomized clinical trial to test the hypothesis that uncomplicated acute appendicitis can be successfully treated with antibiotics by comparing antibiotic therapy with emergency appendectomy,1 which at that time had not yet been established. Because we know that even at long-term follow-up, antibiotic treatment is an effective, safe, and feasible alternative to surgery,2 the aspects of quality of life (QOL), patient satisfaction, and patient choice after receiving unbiased information all need to be recognized and assessed in future trials on adult patient populations. When designing the APPAC trial, such an evaluation was not yet possible, explaining why this OQL and patient satisfaction study was performed as a long-term secondary analysis.3
Identify all potential conflicts of interest that might be relevant to your comment.
Conflicts of interest comprise financial interests, activities, and relationships within the past 3 years including but not limited to employment, affiliation, grants or funding, consultancies, honoraria or payment, speaker's bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued.
Err on the side of full disclosure.
If you have no conflicts of interest, check "No potential conflicts of interest" in the box below. The information will be posted with your response.
Not all submitted comments are published. Please see our commenting policy for details.
Sippola S, Haijanen J, Salminen P. Quality of Life and Patient Satisfaction After Antibiotic Therapy vs Appendectomy for Uncomplicated Appendicitis—Reply. JAMA Surg. 2020;155(10):994. doi:10.1001/jamasurg.2020.2193
Coronavirus Resource Center
Customize your JAMA Network experience by selecting one or more topics from the list below.
Create a personal account or sign in to: