Menus Subscribe Search
(PHOTO: STACIE STAUFFSMITH/SHUTTERSTOCK)

(PHOTO: STACIE STAUFFSMITH/SHUTTERSTOCK)

How Speed Bumps Help Predict Appendicitis

• February 21, 2013 • 4:00 AM

(PHOTO: STACIE STAUFFSMITH/SHUTTERSTOCK)

British physicians discover a slow-speed approach to diagnosing a life-threatening condition.

Time is a killer when it comes to appendicitis. Ignore that howling stomachache long enough, and you risk a burst appendix and infected belly. But the condition is notoriously difficult to diagnose—maybe it’s gas, maybe it’s cramps—and emergency surgery carries risks all its own. For doctors, it’s a choice between two lousy options; the rate of “negative appendectomy,” where the sac is removed only to be found uninflamed, is as high as 42 percent.

As with many diseases, early-stage diagnosis is something of a guessing game. Does the pain seem to migrate from your belly button toward your right hip? Does it ease when you apply pressure, but ache when you let up? What about speed bumps—does it shriek when you bounce over one?

That last question, popular with some ER doctors as a bit of trusty folk medicine, was at the center of a British study which appeared recently in BMJ. Can speed bumps, such as those found in hospital parking lots, be an effective tool for diagnosing—or ruling out—appendicitis in patients with aggravated stomach pain?

With no formal funding, physicians at Stoke Mandeville Hospital, in Buckinghamshire, decided to run a small experiment. They asked 101 suspected appendicitis patients to record whether they recalled hitting any speed bumps on their way to the ER, and if their pain changed as a result. Of the 34 patients who eventually underwent surgery and were found to have a blocked appendix, 33 were “speed bump positive”—in other words, the pain had been jarring.

Of course, there were plenty of patients who reported painful speed bumps and weren’t found to have appendicitis. Statisticians refer to this as “positive” vs. “negative” predictive value: In this case, not experiencing speed bump pain was a good indicator that a patient did not have appendicitis, allowing a doctor to safely rule it out. But bump pain was less useful as a tool to definitively diagnose—or, rule in—the condition.

Like many diagnostic tools doctors rely on, “the speed bump test” narrowed the list of possible suspects, even if it didn’t finger the culprit. And in several cases, it turned up equally dangerous abnormalities, including ruptured ovarian cysts and diverticulitis.

The authors note that, when it comes to appendicitis, asking about speed bump pain is as specific—and thus helpful—a diagnostic tool as asking about nausea, migratory pain, and rebound tenderness. And compared to the cost of a CT scan, the speed bump test is about as cheap as they come.

Ambulance drivers and urban planners, take note.

Kevin Charles Redmon
Kevin Charles Redmon is a journalist and critic. He lives in Washington, D.C.

More From Kevin Charles Redmon

A weekly roundup of the best of Pacific Standard and PSmag.com, delivered straight to your inbox.

Recent Posts

August 20 • 4:00 PM

Why Can’t Conservatives See the Benefits of Affordable Child Care?

Private programs might do a better job of watching our kids than state-run programs, but they’re not accessible to everyone.


August 20 • 2:00 PM

Oil and Gas Companies Are Illegally Using Diesel Fuel in Hundreds of Fracking Operations

An analysis by an environmental group finds hundreds of cases in which drillers used diesel fuel without obtaining permits and sometimes altered records disclosing they had done so.


August 20 • 12:00 PM

The Mystery of Britain’s Alien Big Cats

In a nation where the biggest carnivorous predator is a badger, why are there so many reported sightings of large cats?


August 20 • 10:00 AM

Death Row in Arizona: Where Human Experimentation Is the Rule, Not the Exception

Recent reports show that chemical roulette is the state’s M.O.


August 20 • 9:51 AM

Diversity Is in the Eye of the Beholder

Perception of group diversity depends on the race of the observer and the extent to which they worry about discrimination.


August 20 • 8:40 AM

Psychopathic or Just Antisocial? A Key Brain Difference Tells the Tale

Though psychopaths and antisocial people may seem similar, what occurs in their brains isn’t.


August 20 • 8:00 AM

What the Cost of Raising a Child in America Tells Us About Income Inequality

You’ll spend nearly a quarter of a million dollars to raise a kid in the United States, or about five times the annual median income.


August 20 • 6:00 AM

In Praise of ‘American Greed’

While it remains semi-hidden on CNBC and can’t claim the car chases of Cops, American Greed—now with eight seasons in the books—has proven itself a worthy endeavor.


August 20 • 4:00 AM

Of Course I Behaved Like a Jerk, I Was Just Watching ‘Jersey Shore’

Researchers find watching certain types of reality TV can make viewers more aggressive.


August 20 • 2:00 AM

Concluding Remarks About Housing Affordability and Supply Restricitions

Demand, not supply, plays the dominant role in explaining the housing affordability crisis. The wages are just too damn low.


August 19 • 4:00 PM

Can Lawmakers Only Make Laws That Corporations Allow?

There’s a telling detail in a recent story about efforts to close loopholes in corporate tax laws.




August 19 • 12:00 PM

How ‘Contagion’ Became Contagious

Do ideas and emotions really spread like a virus?


August 19 • 10:00 AM

Child Refugees: The New Barbarians

The disturbing rhetoric around the recent rise in child refugees into the United States from Central America may be shaping popular opinion on upcoming immigration reform.


August 19 • 8:00 AM

Making Police Departments More Diverse Isn’t Enough

Local police departments should reflect the communities they serve, but fixing that alone won’t curb unnecessary violence.


August 19 • 7:15 AM

Common Knowledge Makes Us More Cooperative

People are more inclined to take mutually beneficial risks if they know what others know.


August 19 • 6:00 AM

Seeking a Healthy Public School Lunch? Good Luck

Mystery meat will always win.


August 19 • 4:00 AM

The Positive Effects of Sports-Themed Video Games

New research finds sports-themed video games actually encourage some kids to get onto the field.


August 19 • 1:00 AM

DIY Diagnosis: How an Extreme Athlete Uncovered Her Genetic Flaw

When Kim Goodsell discovered that she had two extremely rare genetic diseases, she taught herself genetics to help find out why.



August 18 • 3:30 PM

Mister Rogers’ Heart-Healthy Neighborhood

Researchers find living in a friendly, cohesive neighborhood lowers seniors’ chances of having a heart attack.


August 18 • 2:00 PM

Wealth or Good Parenting?

Framing the privileges of the rich.


August 18 • 12:00 PM

How Much Did the Stigma of Mental Illness Harm Robin Williams?

Addiction treatment routinely fails people with mental illnesses, while mental health care often ignores addiction. And everywhere, stigma is rife. Can a tragic death prompt a more intelligent approach?


August 18 • 10:00 AM

Punished for Being Poor: The Problem With Using Big Data in the Justice System

Correctional departments use data-driven analyses because they’re easier and cheaper than individual assessments. But at what cost?


Follow us


Diversity Is in the Eye of the Beholder

Perception of group diversity depends on the race of the observer and the extent to which they worry about discrimination.

Psychopathic or Just Antisocial? A Key Brain Difference Tells the Tale

Though psychopaths and antisocial people may seem similar, what occurs in their brains isn’t.

Common Knowledge Makes Us More Cooperative

People are more inclined to take mutually beneficial risks if they know what others know.

How a Shift in Human Head Shape Changed Everything

When did homo sapiens become a more sophisticated species? Not until our skulls underwent "feminization."

Journalists Can Get PTSD Without Leaving Their Desks

Dealing with violent content takes a heavy toll on some reporters.

The Big One

One in two full-time American fast-food workers' families are enrolled in public assistance programs, at a cost of $7 billion per year. July/August 2014 fast-food-big-one
Subscribe Now

Copyright © 2014 by Pacific Standard and The Miller-McCune Center for Research, Media, and Public Policy. All Rights Reserved.