Menus Subscribe Search

Follow us


(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

October 22 • 4:00 PM

The Last Thing the Women’s Movement Needs Is a Heroic Male Takeover

Is the United Nations’ #HeForShe campaign helping feminism?


October 22 • 2:00 PM

Turning Public Education Into Private Profits

Baker Mitchell is a politically connected North Carolina businessman who celebrates the power of the free market. Every year, millions of public education dollars flow through Mitchell’s chain of four non-profit charter schools to for-profit companies he controls.


October 22 • 12:00 PM

Will the End of a Tax Loophole Kill Off Irish Business and Force Google and Apple to Pay Up?

U.S. technology giants have constructed international offices in Dublin in order to take advantage of favorable tax policies that are now changing. But Ireland might have enough other draws to keep them there even when costs climb.


October 22 • 10:00 AM

Veterans in the Ivory Tower

Why there aren’t enough veterans at America’s top schools—and what some people are trying to do to change that.


October 22 • 8:00 AM

Our Language Prejudices Don’t Make No Sense

We should embrace the fact that there’s no single recipe for English. Making fun of people for replacing “ask” with “aks,” or for frequently using double negatives just makes you look like the unsophisticated one.


October 22 • 7:04 AM

My Politicians Are Better Looking Than Yours

A new study finds we judge the cover by the book—or at least the party.


October 22 • 6:00 AM

How We Form Our Routines

Whether it’s a morning cup of coffee or a glass of warm milk before bed, we all have our habitual processions. The way they become engrained, though, varies from person to person.


October 22 • 4:00 AM

For Preschoolers, Spite and Smarts Go Together

New research from Germany finds greater cognitive skills are associated with more spiteful behavior in children.


October 21 • 4:00 PM

Why the Number of Reported Sexual Offenses Is Skyrocketing at Occidental College

When you make it easier to report assault, people will come forward.


October 21 • 2:00 PM

Private Donors Are Supplying Spy Gear to Cops Across the Country Without Any Oversight

There’s little public scrutiny when private donors pay to give police controversial technology and weapons. Sometimes, companies are donors to the same foundations that purchase their products for police.


October 21 • 12:00 PM

How Clever Do You Think Your Dog Is?

Maybe as smart as a four-year-old child?


October 21 • 10:00 AM

Converting the Climate Change Non-Believers

When hard science isn’t enough, what can be done?



October 21 • 8:00 AM

Education Policy Is Stuck in the Manufacturing Age

Refining our policies and teaching social and emotional skills will help us to generate sustained prosperity.


October 21 • 7:13 AM

That Cigarette Would Make a Great Water Filter

Clean out the ashtray, add some aluminum oxide, and you’ve (almost) got yourself a low-cost way to remove arsenic from drinking water.


October 21 • 6:00 AM

Fruits and Vegetables Are About to Enter a Flavor Renaissance

Chefs are teaming up with plant breeders to revitalize bland produce with robust flavors and exotic beauty—qualities long neglected by industrial agriculture.


October 21 • 4:00 AM

She’s Cheating on Him, You Can Tell Just by Watching Them

New research suggests telltale signs of infidelity emerge even in a three- to five-minute video.


October 21 • 2:00 AM

Cheating Demographic Doom: Pittsburgh Exceptionalism and Japan’s Surprising Economic Resilience

Don’t judge a metro or a nation-state by its population numbers.


October 20 • 4:00 PM

The Bird Hat Craze That Sparked a Preservation Movement

How a fashion statement at the turn of the 19th century led to the creation of the first Audubon societies.


October 20 • 2:00 PM

The Risk of Getting Killed by the Police If You Are White, and If You Are Black

An analysis of killings by police shows outsize risk for young black males.


October 20 • 12:00 PM

Love and Hate in Israel and Palestine

Psychologists find that parties to a conflict think they’re motivated by love while their enemies are motivated by hate.


October 20 • 11:00 AM

My Dog Comes First: The Importance of Pets to Homeless Youth

Dogs and cats have both advantages and disadvantages for street-involved youth.


October 20 • 10:00 AM

Homophobia Is Not a Thing of the Past

Despite growing support for LGBT rights and recent decisions from the Supreme Court regarding the legality of same-sex marriage, the battle for acceptance has not yet been decided.


October 20 • 8:00 AM

Big Boobs Matter Most

Medical mnemonics are often scandalous and sexist, but they help the student to both remember important facts and cope with challenging new experiences.


October 20 • 6:00 AM

When Disease Becomes Political: The Likely Electoral Fallout From Ebola

Will voters blame President Obama—and punish Democrats in the upcoming mid-term elections—for a climate of fear?


Follow us


My Politicians Are Better Looking Than Yours

A new study finds we judge the cover by the book—or at least the party.

That Cigarette Would Make a Great Water Filter

Clean out the ashtray, add some aluminum oxide, and you've (almost) got yourself a low-cost way to remove arsenic from drinking water.

Love and Hate in Israel and Palestine

Psychologists find that parties to a conflict think they're motivated by love while their enemies are motivated by hate.

How to Water a Farm in Sandy Ground

Physicists investigate how to grow food more efficiently in fine-grained soil.

Unlocking Consciousness

A study of vegetative patients closes in on the nature of consciousness.

The Big One

One company, Amazon, controls 67 percent of the e-book market in the United States—down from 90 percent five years ago. September/October 2014 new-big-one-5

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