Technology at expense of clinical evaluation will diminish quality of care

EDITOR—Like many others will have been, I was astonished at the assertion in Benjamin and Patel's leader that mortality from negative appendicectomy (1.5%) exceeded that of appendicectomy for acute appendicitis (0.2%).1 It is clear from reading their source document, that this is a seriously misleading statistic, the figure of 1.5% representing the mortality of comorbidity rather than that of the appendicectomy itself.2

In a study of all 805 deaths from appendicitis or appendicectomy in Scotland (population 5 million) over 10 years to 1963, mortality from appendicectomy for appendicitis was 0.62%, and that from negative appendicectomy was 0.06%. Seventy one of the 605 patients (11.7%) for whom clinical records …