Objective: |
To prospectively observe the management of patients with diverticular abscesses. |
Aim: |
1. Prospectively observe the natural history of patients presenting with diverticular abscesses according to initial management at index admission
2. To determine the effectiveness or not of surgical resection (vs. non-surgical management) in patients with diverticular abscesses based on a superiority margin of 0.1 using EQ-5D-5L and 1.0 using MYMOP scores in those patients whom fail initial conservative treatment.
4.3 Secondary Objectives
3. Record national and international variation in initial management (at index admission).
4. Admission (main disease- and patient-specific) covariates that affect initial treatment decisions and may predict failure of surgical/non-surgical management
5. If timing of surgery is important in terms of effectiveness (indicatively whether early is better than late surgery) based on EQ-5D-5L and MYMOP analysis
6. If timing of surgery is important in terms of a basic measure of health utilisation (defined by readmission rates)
7. Correlate patient reported symptoms (MYMOP scores) and quality of life (EQ-5D-5L) in patients with diverticular abscesses
8. Feasibility of creating a long-term observational cohort of patients for further studies of disease biology, genetic risk, including randomised trials of different interventions to manage diverticulitis (trial within a cohort study).
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Methods: |
Prospective, observational only , multicentre study with nested case control study |
Reason for International Trial: |
1. To observe international variation in management at index admission
2. To obtain satisfactory numbers approx. 1000
Please note we plan to open approx. 50 sites across the Tripartite nations for this study. Planned funder is NIHR HTA programme with small programme grants in rets of Tripartite nations |