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

July 31 • 2:00 PM

A New York State of Fracking

Court cases. A governor’s moratorium. Pending health study. A quick guide to the state of fracking in New York.


July 31 • 11:17 AM

How California Could Power Itself Using Nothing but Renewables

We don’t need fossil fuels.


July 31 • 8:00 AM

Should Athletes Train Their Memories?

Sure, but it probably won’t help.


July 31 • 6:00 AM

Universal Basic Income: Something We Can All Agree on?

According to Almaz Zelleke, it’s not a crazy thought.


July 31 • 4:00 AM

Medical Dramas Produce Misinformed, Fatalistic Viewers

New research suggests TV doctor dramas leave viewers with skewed impressions of important health-related topics.


July 30 • 4:00 PM

Still the World’s Top Military Spender

Although declining in real terms, the United States’ military budget remains substantial and a huge drain on our public resources.



July 30 • 2:04 PM

The Rise of the Nuisance Flood

Minor floods are afflicting parts of Maryland nearly 10 times more often than was the case in the 1960s.


July 30 • 2:00 PM

The (Mostly Awful) Things You Learn After Investigating Unpaid Internships for a Year

Though the intern economy remains opaque, dialogue about the role of interns in the labor force—and protections they deserve—is beginning to take shape.


July 30 • 12:00 PM

Why Coffee Shortages Won’t Change the Price of Your Frappuccino

You’re so loyal to Starbucks—and the company knows it—that your daily serving of caffeine is already marked up beyond the reach of any fluctuations in supply.



July 30 • 10:00 AM

Having Difficult Conversations With Your Children

Why it’s necessary, and how to do it.


July 30 • 8:00 AM

How to Make a Convincing Sci-Fi Movie on a Tight Budget

Coherence is a good movie, and its initial shoot cost about the same amount of money as a used Prius.


July 30 • 6:00 AM

Are You Really as Happy as You Say You Are?

Researchers find a universal positivity bias in the way we talk, tweet, and write.


July 30 • 4:00 AM

The Declining Wage Gap for Gay Men

New research finds gay men in America are rapidly catching up with straight married men in terms of wages.


July 30 • 2:00 AM

LeBron James Migration: Big Chef Seeking Small Pond

The King’s return to Cleveland is a symbol for the dramatic shift in domestic as well as international migration.


July 29 • 4:00 PM

Are Children Seeking Refuge Turning More Americans Against Undocumented Immigrants?

A look at Pew Research Center survey data collected in February and July of this year.


July 29 • 2:00 PM

Under Water: The EPA’s Ongoing Struggle to Combat Pollution

Frustration and inaction color efforts to enforce the Clean Water Act.


July 29 • 12:40 PM

America’s Streams Are Awash With Pesticides Banned in Europe

You may have never heard of clothianidin, but it’s probably in your local river.


July 29 • 12:00 PM

Mining Your Genetic Data for Profit: The Dark Side of Biobanking

One woman’s personal story raises deep questions about the stark limits of current controls in a nascent industry at the very edge of the frontier of humans and technology.


July 29 • 11:23 AM

Where Should You Go to College?


July 29 • 10:29 AM

How Textbooks Have Changed the Face of War

War is more personal, less glorious, and more hellish in modern textbooks than in the past. But there’s still room for improvement.


July 29 • 10:00 AM

The Monolingual American: Why Are Those Outside of the U.S. Encouraging It?

If you are an American trying to learn German in a large German town or city, you will mostly hear English in return, even when you give sprechen your best shot.


July 29 • 8:00 AM

The Elusive Link Between Casinos and Crime

With a study of the impact of Philadelphia’s SugarHouse Casino, a heated debate gets fresh ammunition.


July 29 • 6:00 AM

What Are the Benefits of Locking Yourself in a Tank and Floating in Room-Temperature Saltwater?

After three sessions in an isolation tank, the answer’s still not quite clear.


Follow us


Subscribe Now

The Rise of the Nuisance Flood

Minor floods are afflicting parts of Maryland nearly 10 times more often than was the case in the 1960s.

America’s Streams Are Awash With Pesticides Banned in Europe

You may have never heard of clothianidin, but it's probably in your local river.

How Textbooks Have Changed the Face of War

War is more personal, less glorious, and more hellish in modern textbooks than in the past. But there’s still room for improvement.

NASA Could Build Entire Spacecrafts in Space Using 3-D Printers

This year NASA will experiment with 3-D printing small objects in space. That could mark the beginning of a gravity-free manufacturing revolution.

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

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