ArticlePloS one2022
Estimating the potential overdiagnosis and overtreatment of acute appendicitis in Thailand using a secondary data analysis of service utilization before, during and after the COVID-19 lockdown policy.
Article in PloS one, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers, 1 of them a synthesis that pooled it.
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Who cites it
8 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Spontaneous Resolution of Uncomplicated Appendicitis may Explain Increase in Proportion of Complicated Appendicitis During Covid-19 Pandemic: a Systematic Review and Meta-analysis.World journal of surgery · 2023Pooled it
- Appendiceal Perforation as a Potential Indicator of Healthcare Disparities Between Thai and Non-Thai Populations: A Nationwide Study of Public Hospitals in Thailand.Journal of racial and ethnic health disparities · 2026Article
- Article
- Burdens and patterns of gastrointestinal diseases in Thai children: an analysis based on Thai national health coverage data.BMC public health · 2025Article
- Unchanged Faces of Acute Appendicitis: Exploring Presentation and Treatment Amidst the COVID-19 Pandemic.Cureus · 2024Article
- Analyzing the dynamics of complicated and uncomplicated appendicitis during the COVID-19 pandemic in Seoul, Korea: a multifaceted time series approach.Epidemiology and health · 2024Article
- Optimizing Surgical Care Amidst COVID-19: A Scoping Review of Practices and Policies.Healthcare (Basel, Switzerland) · 2023Article
- What, Where, and How to Collect Real-World Data and Generate Real-World Evidence to Support Drug Reimbursement Decision-Making in Asia: A reflection Into the Past and A Way Forward.International journal of health policy and management · 2023Article
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8 authors.
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Abstract
introductionAcute appendicitis is one of the most common surgical emergencies; however, optimal diagnosis and treatment of acute appendicitis remains challenging. We used the coronavirus disease 2019 (COVID-19) lockdown policy as a natural experiment to explore potential overdiagnosis and overtreatment of acute appendicitis in Thailand. The aim of this study was to estimate the potential overdiagnosis and overtreatment of acute appendicitis in Thailand by examining service utilization before, during, and after the COVID-19 lockdown policy.
methodsA secondary data analysis of patients admitted with acute appendicitis under the Universal Coverage Scheme (UCS) in Thailand over a 6-year period between 2016 and 2021 was conducted. The trend of acute appendicitis was plotted using a 14-day rolling average of daily cases. Patient characteristics, clinical management, and outcomes were descriptively presented and compared among three study periods, namely pre-pandemic, lockdown, and post-lockdown.
resultsThe number of overall acute appendicitis cases decreased from 25,407 during pre-pandemic to 22,006 during lockdown (13.4% reduction) and 21,245 during post-lockdown (16.4% reduction). This reduction was mostly due to a lower incidence of uncomplicated acute appendicitis, whereas cases of generalized peritonitis were scarcely affected by the pandemic. There was an increasing trend towards the usage of diagnostic computerized tomography for acute appendicitis but no significant difference in treatment modalities and complication rates.
conclusionThe stable rates of generalized peritonitis and complications during the COVID-19 lockdown, despite fewer admissions overall, suggest that there may have been overdiagnosis and overtreatment of acute appendicitis in Thailand. Policy makers could use these findings to improve clinical practice for acute appendicitis in Thailand and support the efficient utilization of surgical services in the future, especially during pandemics.
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