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PubMed · 502614

Alternative designs to study outcomes: the tonsillectomy case.

L L Roos
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Abstract

This article explores the impact of the tonsillectomy operation using a large data base and several different approaches. The likely range of effects of the surgery and various threats to validity are studied from a quasi-experimental perspective. Information on possible patient self-selection for tonsil surgery is provided. Selection is dealt with from another viewpoint by comparing the outcomes of patients under the care of physicians having a "high propensity to operate" with those going to physicians who tend to operate less. Finally, a computer simulation studies the extent to which the measured results of tonsil surgery might be explained by particular selection mechanisms working in conjunction with random processes of episode generation. The "savings" in respiratory episodes estimated by the various approaches ranges from 0.1 episodes to approximately 0.8 episode for the year following surgery.

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AdenoidectomyAttitude of Health PersonnelComputersData CollectionHumansManitobaOutcome and Process Assessment, Health CarePatientsResearch DesignStatistics as TopicTonsillectomyComparative StudyJournal Article

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BibTeXRIS

L L Roos. 1979. Alternative designs to study outcomes: the tonsillectomy case.. https://doi.org/10.1097/00005650-197911000-00001

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PubMed2007

[Histology after adenoidectomy/tonsillectomy? No conformity in Germany concerning the histopathological examination of adenoids or tonsils in children up to the age of 10 years].

BACKGROUND: It is more and more doubted that adenoids or tonsils have to be examined histologically in pediatric cases, in which history and clinical signs and symptoms are conclusive for chronic inflammation or hyperplasia. It is unknown whether there is any conformity about this question in Germany. METHOD: The heads of all clinical departments of otorhinolaryngology (n=149) and a similar number of ENT specialists from the Berufsverband Deutscher HNO-Arzte (n=150) were surveyed by a simple questionnaire. They were asked if they would routinely send resected tissue for histopathological examination in the case of a child, up to 10 years old, presenting with a history and a status of chronic inflammation or hyperplasia and undergoing adenoidectomy or tonsillectomy. Furthermore they were asked whether they remembered any unusual or surprising report in this group of patients. RESULTS: Feedback was 79%. All tissue was sent for examination by 59% of the colleagues answering this evaluation; palatine tonsils only were sent for examination by 14%, and 27% of the physicians did not send any tissue for histological work-up. During their professional career 17% of the responding ENT specialists had received a surprising result from the histopathological examination. CONCLUSION: We do not have any consensus practiced in Germany concerning the necessity to send tissue for histopathological examination following adenoidectomy or tonsillectomy in children. It seems helpful to seek such consensus of opinion for medicolegal and socioeconomic reasons.

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