Appendicitis can be difficult to diagnose especially for certain groups, and the costs of misdiagnosis are tremendous, yet new diagnostic tools could greatly alleviate this problem. Those are the general conclusions of an economic study Tyco International recently completed with the help of research firm Covance.
Along with the study, Tyco provided information about the complexities of diagnosing appendicitis and showcased an imaging agent NeutroSpec which is designed to greatly assist in diagnosing the ailment, at last week's 52nd Society of Nuclear Medicine (SNM) annual meeting in Toronto, Canada.
Results of the economic study concluded that misdiagnosed cases cost the U.S. nearly $2.46 billion annually in hospital charges, lost wages and medical malpractice claims. The study provides the following general breakdown of costs:
- Lost wages amount to $30 million annually.
- On average, patients miss 10.5 days of work following an unnecessary appendectomy.
- The approximate cost of medical malpractice lawsuits was $130 million in 2004, broken down to $24 million for appendicitis and $106 million for abdominal/pelvic cases.
- A perforated appendix doubles hospital charges and length of stay.
Misdiagnosis is most common among children, women, and the elderly, the study found.
"Children are difficult to diagnose because they don't articulate their symptoms very well. It is also difficult to define their medical history when they come in to the ER," said Jackie E. Groff, Senior Product Manager, Nuclear Medicine, Mallinckrodt Inc., Tyco Healthcare. "The elderly are hard to diagnose because they also have a hard time articulating and also have so many underlying causes. And you don't expect someone who is 60 years old, or 65 or 70 to have appendicitis. It's an acute syndrome that generally occurs in the first four decades of life."
"Woman are very difficult to diagnose just because so many diseases that they have mimic appendicitis. So women are more difficult to diagnose than any other patient population," Groff added.
As a solution to this problem, Tyco provided details about NeutroSpec an imaging agent that is able to non-invasively provide quick and accurate scintigraphic imaging for patients five years of age and above. The benefit of the agent is that is allows physicians to clearly view and understand the function of the appendix instead of simply the anatomy. This is something CT, for example, is not able to provide.
"CT depends on anatomic changes to the body. Yet, someone in the early stages of appendicitis might not have an inflamed appendix, but that doesn't mean it's not infected. CT might miss it," said Groff. "Yet you could have a raised white blood cell count, you could have a fever, and you could still have pain. NeutroSpec will pick it up because it doesn't look at the anatomy it looks at the function of the appendix. It's looking at the white blood cells that have gathered there."
Just like any nuclear medicine technology, Groff added, it gives clinicians an intimate view of the body and what is occurring.
NeutroSpec is marketed through Tyco's Mallinckrodt business that has recently inked an amendment to an existing marketing and distribution deal with Palatin Technologies Inc. to extend the products reach. The original agreement between the companies provided for worldwide distribution with the exception of Europe. Under the terms of the amendment, the companies will jointly develop and commercialize NeutroSpec for global markets, including Europe.
Tyco International and Mallinckrodt Imaging business also recently launched a website devoted to educating consumers and the medical community about appendicitis. For more information visit: www.appendicitisinfo.com