Yes, it’s that time of year again when the world’s media turns it’s fetid gaze upon the science that sounds a bit funny and weird; it’s the Ig Nobels. For those of you that haven’t heard of them the Ig Nobels are a set of awards that highlight unusual sounding research that, in the words of the founder Marc Abrahams, first makes you laugh and then makes you think. It is supposed to be irreverent and amusing but it isn’t an out-and-out piss take; Abrahams has a genuine love of science and isn’t seeking to undermine it.
Winners this year include the prize for Entymology for the guy who made bees sting him in 25 different locations on his body so that he could rank them in order of pain (spoiler alert: being stung on the penis hurts more than being stung on the arm); and the prize for Economics that went to the Bangkok Metropolitan Police for paying their policemen more money if they refused to take bribes.
The one that caught my eye, however, was the work from an English team that determined that acute appendicitis can be accurately diagnosed by the amount of pain evident when the patient drove over speed bumps. Published back in 2012 in the British Medical Journal the study proved to be more useful than you might initially think. 101 patients were recruited to the study, they had all been referred to the on call surgical team for possible appendicitis. Of the 101 people 61 were taken to theatre where 54 of them subsequently had their appendix removed. After further testing it was shown that only 43 of these patients actually had appendicitis and so 20% of them had their appendix removed unnecessarily; not a disaster but surgeries should be avoided if possible to reduce risk of harm to patients and to not waste resources.
After recuperation the patients were questioned on their journey to the hospital. Of the 101 patients 64 of them had travelled over speed bumps and 54 of them said that it was very painful to do so. 34 of this group were found to have appendicitis and 33 of them had reported increased pain when travelling. 7 of those that had increased pain but didn’t have appendicitis were subsequently found to have other complications like ruptured ovarian cysts or diverticulitis. This gives an overall sensitivity of 98% with a specificity of 39%.
So it turns out this can be diagnostically useful. If you find going over speed bumps very painful there is a very good chance that you have some kind of abdominal problem. It can’t tell you which one but it let’s you know you should certainly investigate. It turns out that clinicians had been asking about speed bumps for sometime in their diagnostic workup but there had never been any evidential basis to it before; now there is.