Trial reportChest2015
Prognosis for Spontaneous Resolution of OSA in Children.
Trial report in Chest, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT00560859 (A Randomized Controlled Study of Adenotonsillectomy for Children With Obstructive Sleep Apnea Syndrome), which is not on this map. Cited by 45 papers, 4 of them syntheses that pooled 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.
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.
A Randomized Controlled Study of Adenotonsillectomy for Children With Obstructive Sleep Apnea Syndrome
Who cites it
45 citing papers in PubMed, 4 syntheses or guidelines pooled it, 104 citations in OpenAlex.
- Revisiting the efficiency and necessity of adenotonsillectomy in children with mild obstructive sleep apnea: a systematic review and meta-analysis.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2025Pooled it
- Postoperative Bleeding and Associated Utilization following Tonsillectomy in Children.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2017Pooled it
- Pooled it
- Tonsillectomy Versus Watchful Waiting for Recurrent Throat Infection: A Systematic Review.Pediatrics · 2017Pooled it
- Progression of mild sleep-disordered breathing in children managed with watchful waiting.Journal of clinical sleep medicine : JCSM : official publication of the American Academy of Sleep Medicine · 2026Trial
- Adenotonsillectomy and Blood Pressure in Children With Mild Obstructive Sleep-Disordered Breathing: An Exploratory Analysis of the PATS Randomized Clinical Trial.JAMA otolaryngology-- head & neck surgery · 2025Trial
- Symptoms, Quality of Life, and Executive Function in Children Who Snore.JAMA otolaryngology-- head & neck surgery · 2025Trial
- Utilisation of machine learning to predict surgical candidates for the treatment of childhood upper airway obstruction.Sleep & breathing = Schlaf & Atmung · 2022Trial
- Effectiveness of Adenotonsillectomy vs Watchful Waiting in Young Children With Mild to Moderate Obstructive Sleep Apnea: A Randomized Clinical Trial.JAMA otolaryngology-- head & neck surgery · 2020Trial
- Montelukast for Children with Obstructive Sleep Apnea: Results of a Double-Blind, Randomized, Placebo-Controlled Trial.Annals of the American Thoracic Society · 2016Trial
- Is watchful waiting an alternative to adenotonsillectomy in children with mild to moderate obstructive sleep apnoea?European journal of pediatrics · 2026Review
- Risk Factors, Symptom Burden, and Treatment Response in Pediatric REM-Predominant OSA: Evidence From the Childhood Adenotonsillectomy Trial.Laryngoscope investigative otolaryngology · 2026Article
- Right Ventricular Function and Pulmonary Arterial Coupling in Paediatric Obstructive Sleep Apnea.Echocardiography (Mount Kisco, N.Y.) · 2026Article
- Indications for Adenoidectomy and Tonsillectomy for Obstructive Sleep Apnea in Children and Adolescents.Children (Basel, Switzerland) · 2025Review
- Article
- Impact of Upper Airway Comorbidities and Tonsil/Adenoid Synergistic Effects on Pediatric OSA Severity.Nature and science of sleep · 2025Article
- Neighborhood Disadvantage, Quality of Life, and Symptom Burden in Children with Mild Sleep-disordered Breathing.Annals of the American Thoracic Society · 2024Article
- Resting-State Cerebral Hemodynamics is Associated With Problem Behaviors in Pediatric Sleep-Disordered Breathing.Otolaryngology--head and neck surgery : official journal of American Academy of Otolaryngology-Head and Neck Surgery · 2023Article
- Progression of Obstructive Sleep Apnea Syndrome in Pediatric Patients with Prader-Willi Syndrome.Children (Basel, Switzerland) · 2022Article
- Evaluation of Upper Airway Stimulation for Adolescents With Down Syndrome and Obstructive Sleep Apnea.JAMA otolaryngology-- head & neck surgery · 2022Article
Corrections and comments
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Authors and funding
14 authors at 10 institutions in 1 country.
Funding
Abstract
backgroundAdenotonsillectomy (AT) is commonly performed for childhood OSA syndrome (OSAS), but little is known about prognosis without treatment.
methodsThe Childhood Adenotonsillectomy Trial (CHAT) randomized 50% of eligible children with OSAS to a control arm (watchful waiting), with 7-month follow-up symptom inventories, physical examinations, and polysomnography. Polysomnographic and symptomatic resolution were defined respectively by an apnea/hypopnea index (AHI) <2 and obstructive apnea index (OAI) <1 and by an OSAS symptom score (Pediatric Sleep Questionnaire [PSQ]) < 0.33 with ≥ 25% improvement from baseline.
resultsAfter 194 children aged 5 to 9 years underwent 7 months of watchful waiting, 82 (42%) no longer met polysomnographic criteria for OSAS. Baseline predictors of resolution included lower AHI, better oxygen saturation, smaller waist circumference or percentile, higher-positioned soft palate, smaller neck circumference, and non-black race (each P < .05). Among these, the independent predictors were lower AHI and waist circumference percentile < 90%. Among 167 children with baseline PSQ scores ≥ 0.33, only 25 (15%) experienced symptomatic resolution. Baseline predictors were low PSQ and PSQ snoring subscale scores; absence of habitual snoring, loud snoring, observed apneas, or a household smoker; higher quality of life; fewer attention-deficit/hyperactivity disorder symptoms; and female sex. Only lower PSQ and snoring scores were independent predictors.
conclusionsMany candidates for AT no longer have OSAS on polysomnography after 7 months of watchful waiting, whereas meaningful improvement in symptoms is not common. In practice, a baseline low AHI and normal waist circumference, or low PSQ and snoring score, may help identify an opportunity to avoid AT. TRIAL REGISTRY: ClinicalTrials.gov; No.: NCT00560859; URL: www.clinicaltrials.gov.
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Identifiers
What OpenQuestion holds
Registered trials
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.