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Research Letter |

Engaging Stakeholders in Surgical Research The Design of a Pragmatic Clinical Trial to Study Management of Acute Appendicitis

Anne P. Ehlers, MD1; Giana H. Davidson, MD, MPH1; Bonnie J. Bizzell, MBA, MEd2; Mary K. Guiden2; Elliott Skopin2; David R. Flum, MD, MPH1; Danielle C. Lavallee, PharmD, PhD1
[+] Author Affiliations
1Department of Surgery, University of Washington, Seattle
2The Comparative Effectiveness Research Translation Network, Seattle, Washington
JAMA Surg. 2016;151(6):580-582. doi:10.1001/jamasurg.2015.5531.
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This study describes the development of a pragmatic clinical trial to address questions regarding the use of antibiotics vs appendectomy to treat acute appendicitis.

Evidence from randomized clinical trials in Europe within the past 20 years suggests that antibiotics alone may be used to treat acute appendicitis as an alternative to appendectomy, the standard of care for more than 100 years.1 Despite this, there are concerns about long-term outcomes, especially with regards to quality of life and safety.2 To answer these questions, we designed a pragmatic clinical trial to be conducted in the United States. Engaging health care stakeholders provided an opportunity to assess feasibility of study conduct, identify barriers to implementation, and determine relevant outcomes to inform decision making and translation of evidence to practice. Very little has been written about stakeholder engagement in the context of surgical research,3 especially in the setting of acute conditions. We describe our approach for the development of a stakeholder-informed research proposal to apprise the surgical community on how such a strategy can be used.

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Subjective Information Obtained From Patient Stakeholder Engagement Through Crowdsourcing, Social Media, Blogs, and Surveys
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