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From: Susan <[log in to unmask]>
Sent: 21 June 2015 12:11:41
To: Bewley, Susan
Subject: RE: EBM of appendicectomyThis is of interest, and is another trial that can be added to the body of work.
However, it begs a question about ‘what counts as evidence’ and who/what is being excluded?
When I was clinical director of NHS London, I was unlucky enough to realise we’d had two maternal deaths from appendicitis within a short time in London. Coincidence? Or ‘canary in the mine’? I don’t know, but please see the enclosed letter about the failed treatment of appendicitis with antibiotics in pregnancy we wrote in response to a metaanalysis of same subject.
Maternal death is very rare, but the CEMD has a surveillance function. I did a look back using the Confidential Enquiry into Maternal Deaths (now reinstated in a different form as MBBRACE).
Susan
From: Evidence based health (EBH) <[log in to unmask]> on behalf of Juan Gérvas <[log in to unmask]>
Sent: 20 June 2015 11:02:35
To: [log in to unmask]
Subject: EBM of appendicectomy
-hope it will of interest
-un saludo
-juan gérvas
Contra la percepción de "lo evidente". Efectos positivos beneficiosos de tratar la apendicitis sin apendicectomía.
Against the perceived evidence. Positive benefits of treating appendicitys without appendicetomy.
http://jama.jamanetwork.com/article.aspx?articleid=2320296¿Apendicitis no complicada? Antibióticos en primer término, cirugía si acaso. Ensayo clínico aleatorizado.
Uncomplicated appendicitis? Try antibiotic treatment, delay appendectomy. Randomised clinical trial.
http://jama.jamanetwork.com/article.aspx?articleid=2320315