Evidence map›Paper›PMID 29146633›Full record

Trial reportBMJ open2017

Comparison of Outcomes of antibiotic Drugs and Appendectomy (CODA) trial: a protocol for the pragmatic randomised study of appendicitis treatment.

Giana H Davidson, David R Flum, David A Talan, Larry G Kessler, Danielle C Lavallee, Bonnie J Bizzell, Farhood Farjah, Skye D Stewart, Anusha Krishnadasan, Erin E Carney and 20 more

Registry-linked trialOpen access · goldAbstract readMulticenter StudyPragmatic Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in BMJ open, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT02800785 (The Comparison of Outcomes of Antibiotic Drugs and Appendectomy), which is not on this map. Cited by 9 papers.

0numbers the graph read from it
0cells of the map it votes in
9citing papers in PubMed
3.8field-weighted citation impact, top 6% 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.

NCT02800785 nacompletednot on this map

The Comparison of Outcomes of Antibiotic Drugs and Appendectomy (CODA) Trial

TypeinterventionalSponsorUniversity of WashingtonRan2016 to 2021Enrolled1,552ConditionsAppendicitisArmsCefoxitin, Ertapenem, Moxifloxacin, Tigecycline, Ticarcillin-Clavulanic Acid, Metronidazole plus Cefazolin, Cefuroxime, Ceftriaxone, Cefotaxime, Ciprofloxacin, or Levofloxacin, Appendectomy
3 · Its place in the literature

Who cites it

9 citing papers in PubMed, 39 citations in OpenAlex.

  1. Trial
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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

30 authors at 8 institutions in 1 country.

Giana H DavidsonDepartment of Surgery, University of Washington, Seattle, Washington, USA.
David R FlumDepartment of Surgery, University of Washington, Seattle, Washington, USA.
David A TalanDepartment of Emergency Medicine, Olive-View UCLA Medical Center, Sylmar, California, USA.
Larry G KesslerDepartment of Health Services, University of Washington, Seattle, Washington, USA.
Danielle C LavalleeDepartment of Surgery, University of Washington, Seattle, Washington, USA.
Bonnie J BizzellThe Comparative Effectiveness Research Translation Network, CODA Chair, Patient Advisory Group, Seattle, Washington, USA.
Farhood FarjahDepartment of Surgery, University of Washington, Seattle, Washington, USA.
Skye D StewartDepartment of Surgery, University of Washington, Seattle, Washington, USA.
Anusha KrishnadasanDepartment of Emergency Medicine, Olive-View UCLA Medical Center, Sylmar, California, USA.
Erin E CarneyDepartment of Surgery, University of Washington, Seattle, Washington, USA.
Erika M WolffDepartment of Surgery, University of Washington, Seattle, Washington, USA.
Bryan A ComstockDepartment of Biostatistics, University of Washington, Seattle, Washington, USA.
Sarah E MonsellDepartment of Biostatistics, University of Washington, Seattle, Washington, USA.
Patrick J HeagertyDepartment of Biostatistics, University of Washington, Seattle, Washington, USA.
Annie P EhlersDepartment of Surgery, University of Washington, Seattle, Washington, USA.
Daniel A DeUgarteDepartment of Surgery, Harbor-UCLA Medical Center, Torrance, Califorina, USA.
Amy H KajiDepartment of Emergency Medicine, Harbor-UCLA Medical Center, Torrance, California, USA.
Heather L EvansDepartment of Surgery, Harborview Medical Center, Seattle, Washington, USA.
Julianna T YuDepartment of Emergency, Virginia Mason Medical Center, Seattle, Washington, USA.
Katherine A MandellDepartment of Surgery, Swedish Medical Center-First Hill, Seattle, Washington, USA.
Ian C DotenDepartment of Emergency Medicine, Swedish Medical Center-First Hill, Seattle, Washington, USA.
Kevin S CliveDepartment of Surgery, Madigan Army Medical Center, Fort Lewis, Washington, USA.
Karen M McGraneDepartment of Emergency Medicine, Madigan Army Medical Center, Fort Lewis, Washington, USA.
Brandon C TudorDepartment of Emergency Medicine, Providence Regional Medical Center, Everett, Washington, USA.
Careen S FosterDepartment of Trauma and Acute Care Surgery, Providence Regional Medical Center, Everett, WA, USA.
Darin J SaltzmanDepartment of Surgery, Olive-View UCLA Medical Center, Sylmar, California, USA.
Richard C ThirlbyDepartment of Surgery, Virginia Mason Medical Center, Seattle, Washington, USA.
Erin O LangeDepartment of Surgery, University of Washington, Seattle, Washington, USA.
Amber K SabbatiniDepartment of Emergency Medicine, Harborview Medical Center, Seattle, Washington, USA.
Gregory J MoranDepartment of Emergency Medicine, Olive-View UCLA Medical Center, Sylmar, California, USA.
University of Washington · USOlive View-UCLA Medical Center · USHarborview Medical Center · USMadigan Army Medical Center · USProvidence Regional Medical Center Everett · USSwedish Medical Center · USUCLA Medical Center · USVirginia Mason Medical Center · US

Funding

Renewal: Gastrointestinal Surgery Outcomes Research FellowshipT32DK070555 · NIDDK · UNIVERSITY OF WASHINGTON · PI FLUM, DAVID R · 2010 to 2024
$3.6M
NIDDK NIH HHS T32 DK070555
6 · The paper itself

Abstract

introductionSeveral European studies suggest that some patients with appendicitis can be treated safely with antibiotics. A portion of patients eventually undergo appendectomy within a year, with 10%-15% failing to respond in the initial period and a similar additional proportion with suspected recurrent episodes requiring appendectomy. Nearly all patients with appendicitis in the USA are still treated with surgery. A rigorous comparative effectiveness trial in the USA that is sufficiently large and pragmatic to incorporate usual variations in care and measures the patient experience is needed to determine whether antibiotics are as good as appendectomy.

objectivesThe Comparing Outcomes of Antibiotic Drugs and Appendectomy (CODA) trial for acute appendicitis aims to determine whether the antibiotic treatment strategy is non-inferior to appendectomy. METHODS/ANALYSIS: CODA is a randomised, pragmatic non-inferiority trial that aims to recruit 1552 English-speaking and Spanish-speaking adults with imaging-confirmed appendicitis. Participants are randomised to appendectomy or 10 days of antibiotics (including an option for complete outpatient therapy). A total of 500 patients who decline randomisation but consent to follow-up will be included in a parallel observational cohort. The primary analytic outcome is quality of life (measured by the EuroQol five dimension index) at 4 weeks. Clinical adverse events, rate of eventual appendectomy, decisional regret, return to work/school, work productivity and healthcare utilisation will be compared. Planned exploratory analyses will identify subpopulations that may have a differential risk of eventual appendectomy in the antibiotic treatment arm. ETHICS AND DISSEMINATION: This trial was approved by the University of Washington's Human Subjects Division. Results from this trial will be presented in international conferences and published in peer-reviewed journals. TRIAL REGISTRATION NUMBER: NCT02800785.

Indexed as

AppendectomyAcute DiseaseAnti-Bacterial AgentsAppendicitisHumansLinear ModelsQuality of LifeResearch DesignTreatment OutcomeUnited StatesAnti-Bacterial Agentsadult surgeryappendicitispatient-centred researchtreatment options

Identifiers

PMID29146633
PMCPMC5695382
OpenAlexW2768711575

What OpenQuestion holds

Textmetadata
LicenceCC BY-NC
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.