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Multicentre prospective clinical application of the T14 paediatric outcome tool

  • C Hopkins (a1), R Almeyda (a2), H Alreefy (a1), H Ismail-Koch (a3), J Lim (a4), V Possamai (a5), S Powell (a6), R Sharma (a7) and I Hore (a1)...



This study aimed to measure changes in disease-specific quality of life in children following tonsillectomy or adenotonsillectomy.


A multicentre prospective cohort study was performed involving seven ENT departments in England. A total of 276 children entered the study over a 2-month period: 107 underwent tonsillectomy and 128 adenotonsillectomy. Forty-one children referred with throat problems initially managed by watchful waiting were also recruited. The follow-up period was 12 months. Outcome measures were the T14, parental impressions of their child's quality of life and the number of days absent from school.


One-year follow-up data were obtained from 150 patients (52 per cent). The mean baseline T14 score in the non-surgical group was significantly lower (T14 = 23) than in the tonsillectomy group (T14 = 31) or the adenotonsillectomy group (T14 = 35; p < 0.001). There was a significant improvement in the T14 scores of responders in all groups at follow up. The effect size was 1.3 standard deviations (SD) for the non-surgical group, 2.1 SD for the tonsillectomy group and 1.9 SD for the adenotonsillectomy group. Between-group differences did not reach statistical significance. A third of children in the non-surgical group underwent surgery during the follow-up period.


Children who underwent surgical intervention achieved a significant improvement in disease-specific quality of life. Less severely affected children were managed conservatively and also improved over 12 months, but 1 in 3 crossed over to surgical intervention.


Corresponding author

Address for correspondence: Mr I Hore, c/o ENT Secretaries, Evelina London Children's Hospital at St Thomas’ Hospital Westminster Bridge Road, London SE1 7EH, UK Fax: +44 2071882192 E-mail:


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Preliminary study data were presented in the short papers section of the British Association of Paediatric Otolaryngology Annual Meeting, 21 September 2012, Sheffield, UK



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1Lau, AS, Upile, NS, Wilkie, MD, Leong, SC, Swift, AC. Rising rates of admissions for tonsillitis and neck space abscesses in England, 1991–2011. Ann R Coll Surg Engl 2014;96:307–10
2Is access to surgery a postcode lottery? Royal College of Surgeons of England, 2014. In: [18 July 2014]
3NHS Atlas of Variation in Healthcare for Children and Young Adults, 2012. RightCare. In: [18 July 2014]
4Indications for tonsillectomy and adenotonsillectomy in children. A joint position paper of the Paediatric and Child Health Division of the Royal Australasian College of Physicians and The Australasian Society of Otolaryngology Head and Neck Surgery, 2008. In: [18 July 2014]
5Hopkins, C, Fairley, J, Yung, M, Hore, I, Balasubramaniam, S, Haggard, M, The 14-item Paediatric Throat Disorders Outcome Test: a valid, sensitive, reliable, parent-reported outcome measure for paediatric throat disorders. J Laryngol Otol 2010;124:306–14
6Tonsillectomy and Adenoidectomy in Children with Sleep Disordered Breathing Disorders. Consensus Statement of a UK Multidisciplinary Working Party Royal College of Anesthetists, Sept 2008. In: [18 July 2014]
7Burton, MJ, Glsziou, PP. Tonsillectomy or adeno-tonsillectomy versus non-surgical treatment for chronic/recurrent acute tonsillitis. Cochrane Database Syst Rev 2009;(1):CD001802
8Blakley, BW, Magit, AE. The role of tonsillectomy in reducing recurrent pharyngitis: a systematic review. Otolaryngol Head Neck Surg 2009;140:291–7
9Brietzke, S, Gallagher, D, The effectiveness of tonsillectomy and adenoidectomy in the treatment of pediatric obstructive sleep apnea/hypopnea syndrome: a meta-analysis. Otolaryngol Head Neck Surg 2006;134:979–84
10Schwentner, I, Schmutzhard, J, Schwentner, C, Abraham, I, Hofer, S, Sprinzl, GM. The impact of adenotonsillectomy on children's quality of life. Clin Otolaryngol 2008;33:56–9
11Goldstein, NA, Witsell, DL, Hannley, MT, Weaver, EM, Yueh, B, Smith, TL et al. Quality of life after tonsillectomy in children with recurrent tonsillitis. Otolaryngol Head Neck Surg 2008;138:S9S16
12Lock, C, Wilson, J, Steen, N, Eccles, M, Mason, H, Carrie, S et al. North of England and Scotland Study of Tonsillectomy and Adeno-tonsillectomy in Children (NESSTAC): a pragmatic randomised controlled trial with a parallel non-randomised preference study. Health Technol Assess 2010;14:1190
13Cook, JA. The challenge faced in the design, conduct and analysis of surgical randomised controlled trials. Trials 2009;10:9


Multicentre prospective clinical application of the T14 paediatric outcome tool

  • C Hopkins (a1), R Almeyda (a2), H Alreefy (a1), H Ismail-Koch (a3), J Lim (a4), V Possamai (a5), S Powell (a6), R Sharma (a7) and I Hore (a1)...


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