The Paediatric Approach to Tonsillectomy

Ja, Glover

doi:10.1136/adc.23.113.1

Cited by 28 publications

(15 citation statements)

References 8 publications

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“…Nine articles studied practice variation in tonsillectomy rates in Europe, covering the years from 1938 to 2014. 1,37–44…”

Section: Resultsmentioning

confidence: 99%

“…As mentioned before, Glover was the first to report tremendous variations in age- and sex-specific tonsillectomy rates, between 1932 and 1938, among children living in similar neighbourhoods and having similar illnesses, which he explained in terms of variation in medical opinion (Table 2). 1,37–44,57,58…”

Section: Resultsmentioning

confidence: 99%

“…In total, this review included 21 articles on practice variation in tonsil surgery rates. 1,[37][38][39][40][41][42][43][44][45][46][47][48][49][50][51][52][53][54][55][56] Fifteen articles focused on regional practice variation in tonsillectomy rates, with or without adenoidectomy. Five papers focused on regional practice variation in adenoidectomy rates alone.…”

Section: Variation Outcomesmentioning

confidence: 99%

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The impact of new evidence on regional variation in paediatric tonsillectomy and adenoidectomy: a historical review

et al. 2020

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BackgroundTonsillectomy and adenoidectomy have been among the most commonly performed procedures in children for approximately 100 years. These procedures were the first for which unwarranted regional variation was discovered, in 1938. Indications for these procedures have become stricter over time, which might have reduced regional practice variation.MethodsThis paper presents a historical review on practice variation in paediatric tonsillectomy and adenoidectomy rates. Data on publication year, region, level of variation, methodology and outcomes were collected.ResultsTwenty-one articles on practice variation in paediatric tonsil surgery were included, with data from 12 different countries. Significant variation was found throughout the years, although a greater than 10-fold variation was observed only in the earliest publications.ConclusionNo evidence has yet been found that better indications for tonsillectomy and adenoidectomy have reduced practice variation. International efforts are needed to reconsider why we are still unable to tackle this variation.

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“…Nine articles studied practice variation in tonsillectomy rates in Europe, covering the years from 1938 to 2014. 1,37–44…”

Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Variation Outcomesmentioning

confidence: 99%

See 1 more Smart Citation

The impact of new evidence on regional variation in paediatric tonsillectomy and adenoidectomy: a historical review

et al. 2020

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“…The interesting figures given by Glover (1948) concerning geographical variations in the incidence of tonsillectomy are well known. The Chief Medical Officer of the Ministry of Education has supplied similar figures (1958).…”

mentioning

confidence: 99%

“…This finding is similar to that of Binning (1950), who studied the incidence of tonsillectomy in 263 children who had had the appendix removed, and in 6,254 who had the appendix intact: the percentage of the former group which had had the tonsils removed was twice as great as it was in the controls. Glover (1948) found that tonsillectomy was more common in the well-to-do than in the poor. Douglas & Blomfield (1958), in their study of children under 5, found that many fewer children of unskilled workers were admitted for tonsillectomy than children of black-coated or professional parents.…”

mentioning

confidence: 99%

Discussion: Is the Removal of Tonsils and Adenoids Necessary?

1961

Proceedings of the Royal Society of Medicine

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Der Einfluss sozialer Faktoren und ärztlicher Einstellung auf die Häufigkeit kleiner operativer Eingriffe bei Kindern in Griechenland

et al. 1986

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Data concerning histories of Adenoidectomy (Ad), Tonsillectomy (T) and Appendectomy (Ap) were collected from the escorts (mainly mothers) of 2296 children 3-12 years-old. The children were admitted as outpatients at the First Department of Paediatrics of the University of Athens or the Polyclinic of the Children's Welfare Center of PIKPA in Pireaus, during the last six months of 1983. Among children with median age of about six years, 12 percent had already had at least one operation (Ad, T or Ap); this proportion increased to about 25 percent among children with median age of about 10 years. The cumulative incidence of Ad and/or T was higher among boys, whereas the cumulative incidence of Ap was higher among girls. The age adjusted cumulative incidence of Ap was significantly higher in the lower social class, whereas there was no social gradient with respect to Ad or T. There were strong intra-individual correlations among the three studied operations; in particular the age adjusted cumulative incidence of Ap was 2.9 times higher among children with Ad and/or T than among children without any of these operations. Since there are no apparent biomedical reasons to account for the observed intra-individual associations, it appears likely, that these associations reflect parental or physician's attitudes leading to unjustifiable operations in some of the children.

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The Paediatric Approach to Tonsillectomy

Cited by 28 publications

References 8 publications

The impact of new evidence on regional variation in paediatric tonsillectomy and adenoidectomy: a historical review

The impact of new evidence on regional variation in paediatric tonsillectomy and adenoidectomy: a historical review

Discussion: Is the Removal of Tonsils and Adenoids Necessary?

Der Einfluss sozialer Faktoren und ärztlicher Einstellung auf die Häufigkeit kleiner operativer Eingriffe bei Kindern in Griechenland

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