Dear Drs. Sanchez, Fischkoff, Davidson, and Skeete. Thanks for allowing us to keep learning from your study. Reading your study, there are two contextual issues that, to my view, must be addressed: 1) patient's preferences -as you say, not always considered by physicians- can sometimes have a deleterious effect on outcomes; 2) we are living in pandemic-times, and while it is desirable not to be in the hospital if avoidable, I am not sure that applies to conditions such as appendicitis. In fact, there is a growing collection of articles on the indirect impact of the pandemic on health outcomes among patients who choose not to go to the hospital to "avoid the pandemic". So, here come my questions:
1) what made you approach appendicitis from a patient-subjective view?
2) having seen the need to eventually proceed with an appendectomy in some of the patients assigned to antibiotics, as well as the number of complications in the antibiotics group (at least among those with appendicolith), if you were to advise a patient on what to decide, what would you do?
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