{"doi":"10.1101/2023.06.26.23291565","title":"Complex Patient Perspectives on Evolving Diverticulitis Treatment","abstract":"Background: Despite evidence that antibiotics may not be necessary to treat acute uncomplicated diverticulitis, they remain the mainstay of treatment in the United States. A randomized controlled trial evaluating antibiotic effectiveness could accelerate implementation of an antibiotic-free treatment strategy, but patients may be unwilling to participate. Objective: This study aims to assess patients' attitudes regarding participation in a randomized trial of antibiotics versus placebo for acute diverticulitis, including willingness to participate. Design: This is a mixed-methods study with qualitative and descriptive methods. Settings: Interviews were conducted in a quaternary care emergency department and surveys were administered virtually through a web-based portal. Patients: Patients with either current or previous acute uncomplicated diverticulitis participated. Interventions: Patients underwent semi-structured interviews or completed a web-based survey. Main Outcome measures: Rates of willingness to participate in a randomized controlled trial was measured. Salient factors related to healthcare decision-making were also identified and analyzed. Results: Thirteen patients completed an interview. Reasons to participate included a desire to help others or contribute to scientific knowledge. Doubts about the efficacy of observation as a treatment method were the main barrier to participation. In a survey of 218 subjects, 62% of respondents reported willingness to participate in a randomized clinical trial. \"What my doctor thinks,\" followed by \"What I've experienced in the past\" were the most important decision-making factors. Limitations: There is possible selection bias inherent to using a study to evaluate willingness to participate in a study. Also, the population sampled was disproportionately White compared to the population affected by diverticulitis. Conclusions: Patients with acute uncomplicated diverticulitis maintain complex and varying perceptions of the use of antibiotics. Most surveyed patients would be willing to participate in a trial of antibiotics versus placebo. Our findings support a trial's feasibility and facilitate an informed approach to recruitment and consent.","journal":"medRxiv","year":2023,"id":394756,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":3,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9593,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2023-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":333567,"name":"Kemberlee Bonnet","orcid":"0000-0003-4046-3408","position":1,"is_corresponding":false},{"id":333568,"name":"David G. Schlundt","orcid":"0000-0001-7069-9644","position":2,"is_corresponding":false},{"id":1169623,"name":"Jessie Wrenn","orcid":null,"position":3,"is_corresponding":false},{"id":106002,"name":"Wesley H. Self","orcid":"0000-0002-9300-3045","position":4,"is_corresponding":false},{"id":404153,"name":"Elisa J. Gordon","orcid":"0000-0003-0969-1998","position":5,"is_corresponding":false},{"id":573610,"name":"Alexander T. Hawkins","orcid":"0000-0002-8531-7247","position":6,"is_corresponding":false},{"id":1169302,"name":"Annie Altman-Merino","orcid":"0000-0002-5317-9265","position":0,"is_corresponding":true}],"reference_count":22,"raw_metadata":null,"created_at":"2026-07-19T01:19:14.590635Z","pmid":"37425810","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}