In accordance with a directive issued by the Joint Commission on Accreditation of Hospitals, we at the Newark Beth Israel Hospital organized a Tissue Committee, which began to function in 1955. The physicians appointed were thoroughly briefed as to the purpose of this committee, and worked in close cooperation with the various departments of the hospital to establish a list of recommended and acceptable indications for surgery.1 The justification for surgery was based upon the history, physical examination, and operative findings, but the final opinion as to the pathological changes in the organ removed was based not on the surgeon's description but entirely upon the pathologist's report.
Experience throughout the country2-4 has shown that when the Tissue Committee questions the justification of the surgery performed, the offending procedure is most frequently a gynecologic operation or an appendectomy. This report is concerned only with the question of appendicitis. The