Evidence map›Paper›PMID 24859874›Full record

SynthesisInternational journal of colorectal disease2014

Systematic review: outpatient management of acute uncomplicated diverticulitis.

J D Jackson, T Hammond

Registry-linked trialAbstract readSystematic Review
PubMed Publisher
In one paragraph

Synthesis in International journal of colorectal disease, 2014. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03496090 (Randomized Multicentric Controlled Clinical Trial of Parallel Groups to Evaluate the Non-therapeutic Inferiority of a Free Diet With a Progressive Diet, in the Treatment of Non-complicated Acute Diverticulitis), which is not on this map. Cited by 26 papers, 6 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
26citing papers in PubMed, 6 pooled it
8.8field-weighted citation impact, top 2% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03496090 nacompletednot on this mapstarted 2018, after this paper: background citation

Randomized Multicentric Controlled Clinical Trial of Parallel Groups to Evaluate the Non-therapeutic Inferiority of a Free Diet With a Progressive Diet, in the Treatment of Non-complicated Acute Diverticulitis

TypeinterventionalSponsorHospital General Universitario Reina Sofía de MurciaRan2018 to 2019Enrolled134ConditionsDiverticulitis, Acute Diverticulitis, Diverticulitis, Colonic, Uncomplicated Diverticular DiseaseArmsFree diet, Progressive diet
3 · Its place in the literature

Who cites it

26 citing papers in PubMed, 6 syntheses or guidelines pooled it, 66 citations in OpenAlex.

  1. Guideline
  2. Pooled it
  3. Pooled it
  4. Pooled it
  5. Pooled it
  6. Guideline
  7. Conservative Treatment in Diverticulitis Patients with Pericolic Extraluminal Air and the Role of Antibiotic Treatment.Journal of gastrointestinal surgery : official journal of the Society for Surgery of the Alimentary Tract · 2019
    Trial
  8. Article
  9. Observational
  10. Evidence-based treatment strategies for acute diverticulitis.International journal of colorectal disease · 2021
    Review
  11. Review
  12. Article
  13. Article
  14. Article
  15. Article
  16. Article
  17. Article
  18. Article
  19. Article
  20. Observational
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

2 authors at 2 institutions in 1 country.

J D JacksonBarts and The London School of Medicine and Dentistry, London, UK, welshjohndj@hotmail.com.
T Hammond
Broomfield Hospital · GBQueen Mary University of London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

purpose of reviewAcute uncomplicated diverticulitis is traditionally managed by inpatient admission for bowel rest, intravenous fluids and intravenous antibiotics. In recent years, an increasing number of publications have sought to determine whether care might instead be conducted in the community, with earlier enteral feeding and oral antibiotics. This systematic review evaluates the safety and efficacy of such an ambulatory approach.

methodsMedline, Embase and Cochrane Library databases were searched. All peer-reviewed studies that investigated the role of ambulatory treatment protocols for acute uncomplicated diverticulitis, either directly or indirectly, were eligible for inclusion.

resultsNine studies were identified as being suitable for inclusion, including one randomised controlled trial, seven prospective cohort studies and one retrospective cohort study. All, except one, employed imaging as part of their diagnostic criteria. There was inconsistency between studies with regards to whether patients with significant co-morbidities were eligible for ambulatory care and whether bowel rest therapy was employed. Neither of these variables influenced outcome. Across all studies, 403 out of a total of 415 (97 %) participants were successfully treated for an episode of acute uncomplicated diverticulitis using an outpatient-type approach. Cost savings ranged from 35.0 to 83.0 %.

conclusionCurrent evidence suggests that a more progressive, ambulatory-based approach to the majority of cases of acute uncomplicated diverticulitis is justified. Based on this evidence, the authors present a possible outpatient-based treatment algorithm. An appropriately powered randomised controlled trial is now required to determine its safety and efficacy compared to traditional inpatient management.

Indexed as

Ambulatory CareFluid TherapyAcute DiseaseAnti-Bacterial AgentsDiverticulitisHumansInfusions, IntravenousSeverity of Illness IndexAnti-Bacterial Agents

Identifiers

PMID24859874
OpenAlexW2086516028

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.