Briefly describe a specific question, or set of related questions, about a health care test or treatment that this program should consider.

Percentage of microscopic validation of acute inflammation among appendices removed for acute abdominal pain?

Does your question include a comparison of different health care approaches? (If no, your topic will still be considered.)

no

If yes, explain the specific technologies, devices, drugs, or interventions you would like to see compared:

Without benefit of CT etc. I have removed at least 1,000 with over 90% showing acute inflammation. I always inverted the stump & never saw "stump abscess". Important 2nd ? is delay source w/ "burst", mine=0

What patients or group(s) of patients does your question apply to? (Please include specific details such as age range, gender, coexisting diagnoses, and indications for therapy.)

All patients having Surgical evaluation for "acute abdominal pain"

Are there subgroups of patients that your question might apply to? (For example, an ethnic group, stage or severity of a disease.)

None Known

Describe the health-related benefits you are interested in. (For example, improvements in patient symptoms or problems from treatment or diagnosis.)

Avoiding Stump Appendicitis (after incomplete appendectomy), Purse-string stump inversion is next to impossible laparoscopically.

Describe any health-related risks, side effects, or harms that you are concerned about.

See many current references to "stump appendicitis."

Appropriateness for EHC Program

Does your question include a health care drug, intervention, device, or technology available (or likely to be available) in the U.S.?

yes

Which priority area(s) and population(s) does this topic apply to? (check all that apply)

EHC Priority Conditions (updated in 2008)

None

AHRQ Priority Populations

None

Federal Health Care Program

None

Importance

Describe why this topic is important.

Correct pre-operative diagnosis is always a problem, not new.

What specifically motivated you to ask this question? (For example, you are developing a clinical guideline, working with a policy with large uncertainty about the appropriate approach, costly intervention, new research you have read, items in the media you may have seen, a clinical practice dilemma you know of, etc.)

I had to wait until I became chief of surgery at a small semi-rural hospital, before I even raised the question

Does your question represent uncertainty for clinicians and/or policy-makers? (For example, variations in clinical care, controversy in what constitutes appropriate clinical care, or a policy decision.)

yes

If yes, please explain:

Both, especially clinitians.

Potential Impact

How will an answer to your research question be used or help inform decisions for you or your group?

I'm no longer practicing Surgery.

Describe the timeframe in which an answer to your question is needed.

No rush

Describe any health disparities, inequities, or impact on vulnerable populations your question applies to.

I've always been suspicious of veracity of a history of a "just in time" appendectomy.

Nominator Information

Other Information About You: (optional)

Please choose a description that best describes your role or perspective: (you may select more than one category if appropriate)

I'm no longer practicing Surgery.

Are you making a suggestion as an individual or on behalf of an organization?

Individual

Please tell us how you heard about the Effective Health Care Program

ACS Bulletin