OBJECTIVE: To compare the costs associated with 2 clinical strategies in children with recurrent upper respiratory tract infections (URTIs): immediate adenoidectomy vs an initial watchful waiting strategy. DESIGN: A cost-minimization analysis from a societal perspective including both direct and indirect costs, alongside an open randomized controlled trial with a 2-year follow-up. SETTING: Multicenter study, including 11 general and 2 university hospitals in the Netherlands. PATIENTS: The study population comprised 111 children aged 1 through 6 years, selected for adenoidectomy for recurrent URTIs according to current clinical practice. INTERVENTION: A strategy of immediate adenoidectomy with or without myringotomy or a strategy of initial watchful waiting. MAIN OUTCOMES MEASURES: Difference in median costs during the 2-year follow-up. RESULTS: The median total of direct and indirect costs in the adenoidectomy and watchful waiting group were €1385 (US $1995) and €844 (US $1216) per patient, respectively. The extra costs in the adenoidectomy group are primarily attributable to surgery and visits to the otorhinolaryngologist. Other costs did not differ significantly between the groups. CONCLUSIONS: In children selected for adenoidectomy for recurrent URTIs, immediate adenoidectomy results in an increase in costs, whereas it confers no clinical benefit over an initial watchful waiting strategy. TRIAL REGISTRATION: trialregister.nl Identifier:NTR968; isrctn.org Identifier:ISRCTN03720485.
OBJECTIVE: To compare the costs associated with 2 clinical strategies in children with recurrent upper respiratory tract infections (URTIs): immediate adenoidectomy vs an initial watchful waiting strategy. DESIGN: A cost-minimization analysis from a societal perspective including both direct and indirect costs, alongside an open randomized controlled trial with a 2-year follow-up. SETTING: Multicenter study, including 11 general and 2 university hospitals in the Netherlands. PATIENTS: The study population comprised 111 children aged 1 through 6 years, selected for adenoidectomy for recurrent URTIs according to current clinical practice. INTERVENTION: A strategy of immediate adenoidectomy with or without myringotomy or a strategy of initial watchful waiting. MAIN OUTCOMES MEASURES: Difference in median costs during the 2-year follow-up. RESULTS: The median total of direct and indirect costs in the adenoidectomy and watchful waiting group were €1385 (US $1995) and €844 (US $1216) per patient, respectively. The extra costs in the adenoidectomy group are primarily attributable to surgery and visits to the otorhinolaryngologist. Other costs did not differ significantly between the groups. CONCLUSIONS: In children selected for adenoidectomy for recurrent URTIs, immediate adenoidectomy results in an increase in costs, whereas it confers no clinical benefit over an initial watchful waiting strategy. TRIAL REGISTRATION: trialregister.nl Identifier:NTR968; isrctn.org Identifier:ISRCTN03720485.
Authors: Juliëtte J C M van Munster; Amir H Zamanipoor Najafabadi; Janneke van 't Hooft; Teus A van Barneveld; Stefan Böhringer; Jorrit S Visser; Rolf H Bremmer; Wilco C Peul; Wilbert B van den Hout; Peter Paul G van Benthem Journal: Clin Otolaryngol Date: 2020-12-13 Impact factor: 2.597
Authors: Juliëtte J C M van Munster; Joost J G Wammes; Rolf H Bremmer; Amir H Zamanipoor Najafabadi; Raphael J Hemler; Wilco C Peul; Wilbert B van den Hout; Peter Paul G van Benthem Journal: BMJ Open Date: 2021-07-01 Impact factor: 2.692