Methodology: 3/5 Usefulness: 3/5 Kim K,
Kim YH,
Kim SY,
Kim S,
Lee YJ,
Kim KP,
Lee HS,
Ahn S,
Kim T,
Hwang SS,
Song KJ,
Kang SB,
Kim DW,
Park SH,
Lee KH. N
Engl J Med. 2012 Apr
26;366(17):1596-605
Article Link
This single-centre randomized non-inferiority trial
found that low-dose abdominal CT was non-inferior to standard dose in terms of
negative appendectomy rates with an absolute increase of 0.3% in the low dose
group (0.3, 95% confidence interval -3.8 to 4.6). The group felt this was not a
practice changing study, as it did not include obese patients; there was a high
risk of bias as the interpreting radiologists were not blinded, and it was not
applicable to our clinical practice in Canada where we often obtain an
ultrasound before CT.
By: Dr. Hanzla Tariq (Presented January 2013) Epi
Lesson: Non-inferiority trials are distinct from superiority trials such that
they are designed to determine whether a given intervention is non-inferior by
a pre-specified margin compared to a co…