Paediatric tonsillectomy Impact assessment using a validated patient reported outcome measure (PROM)

• Published in: Clinical governance Vol. 18; no. 2; pp. 132 - 138
• Main Authors: Soni-Jaiswal, Archana, Parry, Nadiah, Kumar, Nirmal
• Format: Journal Article
• Language: English
• Published: 2013
• Subjects: Assessments; Children; Funding; Paediatrics; Parents; Patients; Quality of life; Response rate; Subgroups; Surgery; Tonsillectomy; United Kingdom > UK; England
• ISSN: 1477-7274
• DOI: 10.1108/14777271311317918

Purpose - The published evidence in support of a tonsillectomy is equivocal relying on historical studies using objective outcome measures. Based on this, NICE have suggested that tonsillectomy is a "low clinical value treatment" and its funding curtailed by PCTs. This paper aims to prospectively evaluate the effect of a tonsillectomy on quality of life (QOL) of children affected by recurrent infective tonsillitis using a qualitative patient reported outcome measure (PROM). Design/methodology/approach - Parents of children under the age of 16, undergoing a tonsillectomy, were enrolled. Parents completed a paediatric throat disorders outcome (PTDO) test prior to their child's surgery and then six months post-operatively. Results were analysed using the Mann-Whitney U test. The power of the study was 0.8 to detect a difference of 10 in a total score of 70. Findings - A total of 63 children participated and an 86 per cent response rate was received at six months. The mean total score improved from 31.29 pre-op to 7.41 post-op (p<0.001). The mean score for the first two subgroups remained static but for the remaining 12 sub-groups significantly improved post-op. Originality/value - The study demonstrates that performing tonsillectomies in a carefully selected cohort of children, significantly improves their QOL. It adds to a growing body of evidence that tonsillectomy is not a "low clinical value procedure" and has a substantial impact on the patients' symptoms.