Evidence map›Paper›PMID 25649213›Full record

ArticleBMJ open2015

Tonsillectomy among children with low baseline acute throat infection consultation rates in UK general practices: a cohort study.

Elizabeth Koshy, Hilary Watt, Vasa Curcin, Alex Bottle, Mike Sharland, Sonia Saxena

Open access · goldAbstract read
In one paragraph

Article in BMJ open, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
0.9field-weighted citation impact, top 25% of its field
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 6 citations in OpenAlex.

  1. Pooled it
  2. Article
  3. Factors associated with consultation rates in general practice in England, 2013-2014: a cross-sectional study.The British journal of general practice : the journal of the Royal College of General Practitioners · 2018
    Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors at 3 institutions in 2 countries.

Elizabeth KoshyDepartment of Primary Care and Public Health, Imperial College London, London, UK.
Hilary WattDepartment of Primary Care and Public Health, Imperial College London, London, UK.
Vasa CurcinDepartment of Primary Care and Public Health Sciences, Kings College London, London, UK.
Alex BottleDepartment of Primary Care and Public Health, Imperial College London, London, UK.
Mike SharlandPaediatric Infectious Diseases Research Group, St George's University London, London, UK.
Sonia SaxenaDepartment of Primary Care and Public Health, Imperial College London, London, UK.
Imperial College London · GBKing's College London · GBSt George's, University of London · GB

Funding

Department of Health CDF-2011-04-048Department of Health DRF-2009-02-78
6 · The paper itself

Abstract

objectiveTo investigate the effectiveness of tonsillectomy in reducing acute throat infection (ATI) consultation rates over 6 years' follow-up among children with low baseline ATI consultation rates.

designRetrospective cohort study.

settingUK general practices from the Clinical Practice Research Datalink.

participantsChildren aged 4-15 years with ≤3 ATI consultations during the 3 years prior to 2001 (baseline). 450 children who underwent tonsillectomy (tonsillectomy group) and 13 442 other children with an ATI consultation (comparison group) in 2001.

main outcome measuresMean differences in ATI consultation rates over the first 3 years' and subsequent 3 years' follow-up compared with 3 years prior to 2001 (baseline); odds of ≥3 ATI consultations at the same time points.

resultsAmong children in the tonsillectomy group, the 3-year mean ATI consultation rate decreased from 1.31 to 0.66 over the first 3 years' follow-up and further declined to 0.60 over the subsequent 3 years' follow-up period. Compared with children who had no operation, those who underwent tonsillectomy experienced a reduction in 3-year mean ATI consultations per child of 2.5 (95% CI 2.3 to 2.6, p<0.001) over the first 3 years' follow-up, but only 1.2 (95% CI 1.0 to 1.4, p<0.001) over the subsequent 3 years' follow-up compared with baseline, respectively. This equates to a mean reduction of 3.7 ATI consultations over a 6-year period and approximates to a mean annual reduction of 0.6 ATI consultations per child, per year, over 6 years' follow-up. Children who underwent tonsillectomy were also much less likely to experience ≥3 ATI consultations during the first 3 years' follow-up (adjusted OR=0.12, 95% CI 0.08 to 0.17) and the subsequent 3 years' follow-up (adjusted OR=0.24, 95% CI 0.14 to 0.41).

conclusionsAmong children with low baseline ATI rates, there was a statistically significant reduction in ATI consultation rates over 6 years' follow-up. However, the relatively modest clinical benefit needs to be weighed against the potential risks and complications associated with surgery.

Indexed as

General PracticeTonsillectomyAcute DiseaseAdolescentChildChild, PreschoolFemaleHumansMaleOdds RatioOutcome Assessment, Health CarePharyngitisPharynxPrevalenceReferral and ConsultationRetrospective StudiesPRIMARY CARE

Identifiers

PMID25649213
PMCPMC4322199
OpenAlexW1976643206

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.