The investigators primary outcome measure was the clinically important change in diagnostic
accuracy and physical examination in the morphine vs. placebo group. After follow up
information was obtained and patients data were recorded on the SPSS data chart, two blinded
coauthors (general surgeon and emergency physician) determined the clinically important
diagnostic accuracy and change in physical examination. They firstly defined clinically
important diagnostic errors, as any disagreement between the preliminary and final diagnosis
that might be expected to have adverse effect on the patient's general status. If coauthors
decided an instance of diagnostic error as clinically important, this was coded "diagnostic
discordance" for statistical analysis. While the preliminary diagnosis was determined as
accurate or not different from the final diagnosis, this was coded "diagnostic accuracy" for
statistical analysis. Secondary outcome measures included the need for rescue drugs at 30
minutes, the presence of at least one adverse event, demographic features and final diagnosis
of the patients.