Success in Diverticulitis Management: What Outcomes Really Matter?

Abstract

Achieving optimal outcomes is a universal goal among health care providers. However, disagreement often arises when selecting and measuring endpoints as markers of care performance. In diverticulitis, this task is complicated by variability in clinical presentation and existence of multiple evidence-based therapeutic options. The aim of this review is to summarize trends and challenges in outcomes measurement for diverticulitis. We discuss historical origins and compare existing frameworks for classifying outcomes. Next, focus is directed to an exploration of important outcomes through clinical controversies: antibiotics for acute uncomplicated diverticulitis, colectomy with primary anastomosis for acute complicated diverticulitis, and elective colectomy for recurrent diverticulitis. Finally, we review recommendations supporting case-by-case decision-making and implications for clinicians, in addition to ongoing international efforts to standardize outcomes that matter for common diseases.

Keywords: diverticulitis; outcomes measurement; patient-reported outcome measures; shared decision-making.

Fig. 1

Outcomes from PubMed-indexed studies of diverticulitis through November 2023. ( A ) Counts of studies reporting an outcome type in their title or abstract. LOS, length of stay; PROM, patient-reported outcome measure; QoL, quality of life. ( B ) Proportion of studies with PROMs stratified by publication date relative to 2014. An identical stratification with all other outcomes is shown for reference.