Methodology: 3/5 Usefulness: 3/5 Chabok A, Påhlman L, Hjern F, Haapaniemi S, Smedh K; AVOD Study Group. Br J Surg. 2012 Apr;99(4):532-9
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An open label multicenter RCT from Sweden comparing usual antibiotic
treatment versus no antibiotics (IV fluids only) in the treatment of acute
uncomplicated diverticulitis showed that there was no statistical difference in
rate of complications while in hospital or in a 12 month follow-up period (1.0%
vs. 1.9% complication rate in Abx vs no Abx group P=0.302). Due to study
limitations such as the lack of blinding, possible selection bias for milder
cases and lack of power, JC attendees were not convinced to yet change our
current practice.
By: Dr. Lisa Harman (Presented January 2013) Epi
Lesson: Open label trials may be promoted as pragmatic trials but a lack of
blinding to treatment allocation is a fundamental threat to internal validity.
Blinding reduces ascertainment bias (the likelihood of differential assessment
of outcome). It is not alwa…