J J C M van Munster1,2, A H Zamanipoor Najafabadi2, J W Schoones3, W C Peul2, W B van den Hout4, P P G van Benthem1. 1. Department of Otorhinolaryngology and Head and Neck Surgery, Leiden University Medical Center, Leiden and the Hague, the Netherlands. 2. University Neurosurgical Center Holland (affiliation of Leiden University Medical Center, the Hague Medical Center, and Haga Teaching Hospitals), Leiden and the Hague, the Netherlands. 3. Walaeus Library, Leiden University Medical Center, Leiden and the Hague, the Netherlands. 4. Biomedical Data Sciences, Leiden University Medical Center, Leiden and the Hague, the Netherlands.
Abstract
BACKGROUND: Tonsillectomy 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. METHODS: This 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. RESULTS: Twenty-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. CONCLUSION: No 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.
BACKGROUND: Tonsillectomy 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. METHODS: This 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. RESULTS: Twenty-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. CONCLUSION: No 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.
Entities:
Keywords:
Adenoidectomy; Guidelines Adherence; Professional Practice; Tonsillectomy
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