Evidence map›Paper›PMID 33441315›Full record

Trial reportArchives of disease in childhood2021

CONservative TReatment of Appendicitis in Children: a randomised controlled feasibility Trial (CONTRACT).

Nigel J Hall, Simon Eaton, Frances C Sherratt, Isabel Reading, Erin Walker, Maria Chorozoglou, Lucy Beasant, Wendy Wood, Michael Stanton, Harriet Corbett and 7 more

Erratum issuedOpen access · hybridAbstract readRandomized Controlled TrialMulticenter Study
PubMed Full text at PMC Publisher
In one paragraph

Trial report in Archives of disease in childhood, 2021. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 17 papers, 4 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
17citing papers in PubMed, 4 pooled it
5.3field-weighted citation impact, top 4% 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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

17 citing papers in PubMed, 4 syntheses or guidelines pooled it, 29 citations in OpenAlex.

  1. Pooled it
  2. Pooled it
  3. Guideline
  4. Pooled it
  5. Trial
  6. Article
  7. Observational
  8. Article
  9. Article
  10. Article
  11. Assessing micro- vs macro-costing approaches for treating appendicitis in children with appendicectomy or non-operatively.Quality of life research : an international journal of quality of life aspects of treatment, care and rehabilitation · 2023
    Article
  12. Observational
  13. Article
  14. Review
  15. Article
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  17. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

17 authors at 9 institutions in 1 country.

Nigel J HallUniversity Surgery Unit, Faculty of Medicine, University of Southampton, Southampton, UK n.j.hall@soton.ac.uk.ORCID 0000-0001-8570-9374
Simon EatonUCL Great Ormond Street Institute of Child Health, London, UK.ORCID 0000-0003-0892-9204
Frances C SherrattDepartment of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool, UK.
Isabel ReadingPrimary Care, Population Sciences and Medical Education, Faculty of Medicine, University of Southampton, Southampton, UK.
Erin WalkerGreat Ormond Street Hospital for Children NHS Foundation Trust, London, UK.
Maria ChorozoglouSouthampton Health Technology Assessment Centre, Faculty of Medicine, University of Southampton, Southampton, UK.ORCID 0000-0001-5070-4653
Lucy BeasantCentre for Academic Child Health, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK.
Wendy WoodNational Institute of Health Research (NIHR), Research Design Service South Central, University of Southampton, Southampton, UK.
Michael StantonDepartment of Paediatric Surgery and Urology, Southampton Children's Hospital, Southampton, UK.
Harriet CorbettDepartment of Paediatric Surgery, Alder Hey Children's NHS foundation Trust, Liverpool, UK.
Dean RexDepartment of Paediatric Surgery, St George's University Hospitals NHS Foundation Trust, London, UK.
Natalie HutchingsSouthampton Clinical Trials Unit, University of Southampton, Southampton, UK.
Elizabeth DixonSouthampton Clinical Trials Unit, University of Southampton, Southampton, UK.
Simon GristPatient and Public Involvement Representative, Southampton, UK.
Esther M CrawleyCentre for Academic Child Health, Bristol Medical School: Population Health Sciences, University of Bristol, Bristol, UK.
Bridget YoungDepartment of Public Health, Policy and Systems, Institute of Population Health, University of Liverpool, Liverpool, UK.
Jane M BlazebyCentre for Surgical Research and NIHR Bristol Biomedical Research Centre, Population Health Sciences, Bristol Medical School, University of Bristol, Bristol, UK.
University of Southampton · GBUniversity of Bristol · GBSouthampton Children's Hospital · GBUniversity of Liverpool · GBAlder Hey Children's NHS Foundation Trust · GBGreat Ormond Street Hospital · GBGreat Ormond Street Hospital for Children NHS Foundation Trust · GBSouthampton City Council · GBSt George’s University Hospitals NHS Foundation Trust · GB

Funding

Department of Health 14/192/90Medical Research Council MR/K025643/1
6 · The paper itself

Abstract

objectiveTo establish the feasibility of a multicentre randomised controlled trial to assess the effectiveness and cost-effectiveness of a non-operative treatment pathway compared with appendicectomy in children with uncomplicated acute appendicitis.

designFeasibility randomised controlled trial with embedded qualitative study to inform recruiter training to optimise recruitment and the design of a future definitive trial.

settingThree specialist paediatric surgery centres in the UK. PATIENTS: Children (aged 4-15 years) with a clinical diagnosis of uncomplicated acute appendicitis.

interventionsAppendicectomy or a non-operative treatment pathway (comprising broad-spectrum antibiotics and active observation).

main outcome measuresPrimary outcome measure was the proportion of eligible patients recruited. Secondary outcomes evaluated adherence to interventions, data collection during follow-up, safety of treatment pathways and clinical course.

resultsFifty per cent of eligible participants (95% CI 40 to 59) approached about the trial agreed to participate and were randomised. Repeated bespoke recruiter training was associated with an increase in recruitment rate over the course of the trial from 38% to 72%. There was high acceptance of randomisation, good patient and surgeon adherence to trial procedures and satisfactory completion of follow-up. Although more participants had perforated appendicitis than had been anticipated, treatment pathways were found to be safe and adverse event profiles acceptable.

conclusionRecruitment to a randomised controlled trial examining the effectiveness and cost-effectiveness of a non-operative treatment pathway compared with appendicectomy for the treatment of uncomplicated acute appendicitis in children is feasible. TRIAL REGISTRATION NUMBER: ISRCTN15830435.

Indexed as

AppendectomyAppendicitisConservative TreatmentFeasibility StudiesAcute DiseaseAdolescentAnti-Bacterial AgentsChildChild, PreschoolCost-Benefit AnalysisFemaleHumansMalePatient SelectionTreatment OutcomeUnited KingdomAnti-Bacterial Agentsgastroenterologyhealth services researchqualitative researchtherapeutics

Identifiers

PMID33441315
PMCPMC8311091
OpenAlexW3120201145

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.