Skip to main content
Log in

Impact of journal articles and grand rounds on practice: CT scanning in appendicitis

  • Published:
Journal of Gastrointestinal Surgery

Abstract

The purpose of this study was to determine whether a report in a high-impact journal published in January 1998 changed practice patterns and to further explore the impact of a review of the subject in a department of surgery grand rounds (January 2000). Charts from all patients undergoing appendectomy at our institution during three time periods (January to December 1997, January to December 1999, and January to June 2000) were reviewed. Rates of CT scanning, negative appendectomy, and perforated/ gangrenous appendicitis were compared for the three periods to determine the impact of the journal article and the subject review during grand rounds on practice patterns and outcomes. Charts from 230 (88%) of 262 patients who underwent appendectomy during the time periods were available for review. Age, percentage of male patients, temperature on admission, and white blood cell count did not differ among the groups. The rate of CT scanning increased significantly from 1997 to 1999 and again in 2000 (6.7%, 43%, and 70%, respectively; P < 0.001), whereas the proportion of perforated/gangrenous appendicitis decreased significantly from 33% in 1997 and 31% in 1999 to 13% in 2000 (P = 0.012). The use of CT scanning in appendicitis increased both after publication of a report in a high-impact journal and after review during grand rounds. A rate of CT scanning above 45 % appeared to affect outcomes as well.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  1. Morrow M, White J, Moughan J, Owen J, Pajack T, Sylvester J, Wilson JF, Winchester D. Factors predicting the use of breast-conserving therapy in stage I and II breast carcinoma. J Clin Oncol 2001;19:2254–2262.

    PubMed  CAS  Google Scholar 

  2. Mandelblatt JS, Berg CD, Meropol NJ, Edge SB, Gold K, Hwang YT, Hadley J. Measuring and predicting surgeons’ practice styles for breast cancer treatment in older women. Med Care 2001;39:228–242.

    Article  PubMed  CAS  Google Scholar 

  3. Cooke M, Mattick RP, Walsh RA. Differential uptake of a smoking cessation programme disseminated to doctors and midwives in antenatal clinics. Addiction 2001;96:495–505.

    Article  PubMed  CAS  Google Scholar 

  4. Dieperink ME, Drogemuller L. Industry-sponsored grand rounds and prescribing behavior. JAMA 2001;285:1443–1444.

    Article  PubMed  CAS  Google Scholar 

  5. Lemelin J, Hogg W, Baskerville N. Evidence to action: A tailored multifaceted approach to changing family physician practice patterns and improving preventive care. CMAJ 2001;164:757–763.

    PubMed  CAS  Google Scholar 

  6. Rao PM, Rhea JT, Novelline RA, Mostafavi AA, McCabe CJ. Effect of computed tomography of the appendix on treatment of patients and use of hospital resources. N Engl J Med 1998;338:141–146.

    Article  PubMed  CAS  Google Scholar 

  7. Neill RA, Bowman MA, Wilson JP. Journal article content as a predictor of commitment to change among continuing medical education respondents. J Contin Educ Health Prof 2001;21:40–45.

    Article  PubMed  CAS  Google Scholar 

  8. Veninga CC, Denig P, Pont LG, Haaijer-Ruskamp FM. Comparison of indicators assessing the quality of drug prescribing for asthma. Health Serv Res 2001;36:143–161.

    PubMed  CAS  Google Scholar 

  9. Minne L, Varner D, Burnell A, Ratzer E, Clark J, Haun W. Laparoscopic versus open appendectomy. Prospective randomized study of outcomes. Arch Surg 1997;132:708–712.

    PubMed  CAS  Google Scholar 

  10. Jones B, Ratzer E, Clark J, Zeren F, Haun W. Does peerreviewed publication change the habits of surgeons? Am J Surg 2000;180:566–569.

    Article  PubMed  CAS  Google Scholar 

  11. PubMed literature search using keywords "CT scan" and "appendicitis" for years 1998 and 1999.

  12. Lane MJ, Liu DM, Huynh MD, Jeffrey RB Jr, Mindelzun RE, Katz DS. Suspected acute appendicitis: Nonenhanced helical CT in 300 consecutive patients. Radiology 1999;213:341–346.

    PubMed  CAS  Google Scholar 

  13. Flum DR, Morris A, Koepsell T, Dellinger EP. Has misdiagnosis of appendicitis decreased over time? A population-based analysis. JAMA 2001; 10:286:1748–1753.

    Article  Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Corresponding author

Correspondence to Leigh Neumayer M.D., M.S..

Rights and permissions

Reprints and permissions

About this article

Cite this article

Neumayer, L., Wako, E., Fergestaad, J. et al. Impact of journal articles and grand rounds on practice: CT scanning in appendicitis. J Gastrointest Surg 6, 338–341 (2002). https://doi.org/10.1016/S1091-255X(01)00088-9

Download citation

  • Issue Date:

  • DOI: https://doi.org/10.1016/S1091-255X(01)00088-9

Key words

Navigation