Perception of treatment success and impact on function with antibiotics or appendectomy for appendicitis. A randomized clinical trial with an observational cohort.

Thompson C, Voldal E, Davidson GH, Sanchez SE, Ayoung-Chee P, Victory J et al, Writing Group for the CODA Collaborative.

Ann Surg 2023; 277: 886-893.

This trial consisted of two cohorts, 1552 randomized and 510 observed patients who declined randomization. Four patient reported outcomes were studied. Patients who had surgery experienced more regret and dissatisfaction; patients who had antibiotics missed more work.

Comment: I like this for two reasons: (i) it includes a non-randomized cohort too; and (ii) it studies outcomes that matter to patients. The issue is that  the learning is more complex and interpretation more subtle.