The treatment of simple appendicitis in children Advancing research to optimise treatment

This thesis provides information on the non-operative treatment strategy for acute simple appendicitis in children. Research in the thesis shows that non-operative treatment with antibiotics is associated with a relatively quick clinical recovery. And with this strategy appendectomy can be avoided in 70% of patients, even after 5-years follow-up. To improve future research, the thesis includes a core outcomes set, a minimal collection of outcomes that should be measured and reported in all future clinical trials evaluating treatments of acute simple appendicitis in children. With the introduction of the new EU legislation for clinical trials future clinical trials will probably be easier to execute, a chapter discussing this is also part of this thesis. Despite the fact that we still need to wait for the results from large well–designed randomized controlled trials, this thesis includes important information for developing implementation strategies for non-operative treatment derived from a qualitative study with children, parents and professionals.