Credit: Sam Greenhalgh
BMJ is fully with the Christmas spirit this year publishing a number of fun and quirky, and even useful, research stories. As an example, clinical researchers from Department of Primary Care Health Sciences, University of Oxford and Department of Surgery, Stoke Mandeville Hospital in the UK wanted to know whether trusty old speed bumps could help doctors diagnose appendicitis in incoming patients.
Instead of actually taking patients back on the road after they arrived, the researchers used a questionnaire to find out whether there were speed bumps on the way to the hospital and what effect they had on the pain. The results are quite promising and suggest that new patients should be asked about their ride before they saw the doctor.
From the study abstract:
Results The analysis included 64 participants who had travelled over speed bumps on their journey to hospital. Of these, 34 had a confirmed histological diagnosis of appendicitis, 33 of whom reported increased pain over speed bumps. The sensitivity was 97% (95% confidence interval 85% to 100%), and the specificity was 30% (15% to 49%). The positive predictive value was 61% (47% to 74%), and the negative predictive value was 90% (56% to 100%). The likelihood ratios were 1.4 (1.1 to 1.8) for a positive test result and 0.1 (0.0 to 0.7) for a negative result. Speed bumps had a better sensitivity and negative likelihood ratio than did other clinical features assessed, including migration of pain and rebound tenderness.
Conclusions Presence of pain while travelling over speed bumps was associated with an increased likelihood of acute appendicitis. As a diagnostic variable, it compared favourably with other features commonly used in clinical assessment. Asking about speed bumps may contribute to clinical assessment and could be useful in telephone assessment of patients.
Open access study in BJM: Pain over speed bumps in diagnosis of acute appendicitis: diagnostic accuracy study
Press release: Speed bumps could be a new way to help diagnose appendicitis
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