Funds awarded by the Patient-Centered Outcomes Research Institute
A University of Washington team, co-led by Project Leads Dr. Giana Davidson and Dr. David Flum, has been approved for a $2 million funding award by the Patient-Centered Outcomes Research Institute (PCORI) to disseminate and implement research findings from the Comparison of Outcomes of Antibiotic Drugs and Appendectomy (CODA) trial on treatments for appendicitis. Even the most impactful findings from clinical research studies can take years to make it into widespread clinical practice. Cutting that lag time and smoothing the path to uptake is the focus of this PCORI-funded project.
The recently completed CODA Trial compared antibiotic therapy as an alternative to appendectomy in 1552 patients for the treatment of appendicitis. CODA was completed in 25 hospitals across the US to include a in a diverse population with a broad range of severity of appendicitis and clinical practices. The CODA trial found that antibiotics were non-inferior or “as good as” appendectomy, when considering the patient outcome reporting on their general health status (measured by the EQ5D quality-of-life questionnaire) at 30 days. They were a safe option for treatment, and approximately 7 of 10 participants assigned to receive antibiotics were able to avoid surgery in the early period.
The newly funded Treatment Individualized Appendicitis Decision-making (TRIAD) implementation program will lead to more informed decision making related to appendicitis treatment. “We need tools to support shared decision making for our patients, especially in emergency general surgery,” said Dr. Davidson. “Patients have differing levels of access to information and treatment options for many reasons – health literacy, acute pain, primary language, and other reasons. It is critically important to effectively communicate with all of our patients, and TRIAD will help us do that.” TRIAD is an implementation strategy that includes: 1) a patient-facing decision aid (www.appyornot.org); 2) a clinician and allied health professional training program; and 3) a system-level, operational protocol to support treatment decisions. The team will implement TRIAD at 15 US hospitals, involving over 2500 patients. Anticipated results of TRIAD include increased patient awareness of treatment options and less regret or dissatisfaction with treatment choice and improvements in clinician and staff knowledge around treatment for appendicitis.
Published Monday, August 15, 2022