Randomized Controlled Trial of a Patient Activation Tool in Pediatric Appendicitis (Antibiotics Alone vs. Appendectomy)
Randomized Controlled Trial of a Patient Activation Tool in Pediatric Appendicitis (Antibiotics Alone vs. Appendectomy)
The purpose of this study is to determine if a patient activation tool (PAT) can improve
 decision making and patient centered outcomes in pediatric patients with appendicitis and
 their caregivers choosing between antibiotics alone and appendectomy.
The objective of this study is to to determine if a patient activation tool (PAT) can improve
 decision making and patient centered outcomes in pediatric patients with appendicitis and
 their caregivers.

 Hypothesis: A PAT that activates patient-caregiver dyads will improve decision making and
 patient centered outcomes without compromising medical outcomes in children with
 appendicitis. Specifically,the investigators expect the PAT to improve decision self-efficacy
 and healthcare satisfaction without increasing disability days.

 Methods/Outcomes: The investigators will perform a randomized controlled trial comparing a
 PAT to standard surgical consultation in patient-caregiver dyads choosing between either
 antibiotics alone or appendectomy for early appendicitis. The investigators will identify
 differences in various components of decision making and patient centered outcomes including
 caregiver decision self-efficacy, preparedness for decision making, decisional conflict,
 decision regret, caregiver activation, caregiver and child satisfaction with care and health
 related quality of life (HRQOL), and caregiver and child knowledge. The investigators will
 also characterize the effects of a PAT on medical outcomes from appendicitis in patients
 receiving the PAT compared to those receiving standard surgical consultation alone. The
 investigators will determine differences in disability days, length of stay, readmission
 rates, and medical complications related to treatment choice (e.g. infection, recurrence).
Inclusion Criteria:

 -  Age : 7-17 years

 -  Ultrasound (US) or Computed Tomography (CT) confirmed early appendicitis:

 -  US: hyperemia, <1.1 cm in diameter, compressible or non-compressible, no abscess,
 no fecalith, no phlegmon

 -  CT: hyperemia, fat stranding, <1.1 cm in diameter, no abscess, no fecalith, no
 phlegmon

 -  White Blood Cell count < 18,000

 -  C-reactive Protein<4 (if obtained)

 -  Focal abdominal pain </= 48 hours prior to receiving antibiotics

 Exclusion Criteria:

 -  Positive urine pregnancy test

 -  Other significant co-morbidities:

 -  cardiovascular disease

 -  malignancy

 -  pulmonary disease

 -  severe developmental delay