Tonsillectomy versus tonsillotomy: A study of parental preference

Stasio, Sally D.; Yang, Charles; Brietzke, Scott E.; Shah, Rahul K.

doi:10.1016/j.ijporl.2014.12.026

Cited by 5 publications

(2 citation statements)

References 13 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…7, 19–21 Studies in other pediatric surgical subspecialties have demonstrated risk aversion behavior amongst parents considering surgical treatment for their children. 20, 22 Despite their fervent desire for positive outcomes, parents and other adults display reluctance to consent children for risky or invasive therapies, preferring safer options if available even if less efficacious. It is reasonable to assume this differential would similarly persist when respondents consider hypothetical pediatric TTO scenarios.…”

Section: Discussionmentioning

confidence: 99%

Utility Estimation for Pediatric Vesicoureteral Reflux: Methodological Considerations Using an Online Survey Platform

et al. 2017

View full text Add to dashboard Cite

BACKGROUND The advent of online task-distribution has opened a new avenue to efficiently gather community perspectives needed for utility estimation. Methodological consensus for estimating pediatric utilities is lacking, with disagreement over whom to sample, what perspective (patient vs. parent), and whether instrument-induced anchoring bias is significant. We sought to determine what methodological factors potentially impact utility estimates for vesicoureteral reflux (VUR). DESIGN Cross-sectional surveys using a time-trade-off (TTO) instrument were conducted via Amazon's Mechanical Turk online interface; respondents were randomized to answer questions from child, parent, or dyad perspectives on the utility of a VUR health state and one of three “warm-up” scenarios (paralysis, common cold, none) prior to a VUR scenario. Utility estimates and potential predictors were fitted to a generalized linear model to determine what factors most impacted utilities. RESULTS A total of 1,627 responses were obtained. Mean respondent age was 34.9 years; 48% were female; 38% were married; and 44% had children. Utility values were uninfluenced by child/personal VUR/UTI history, income, or race. Utilities were affected by perspective, and were higher in the child group (34% lower in parent v. child, p<0.001; 13% lower in dyad v. child, p<0.001). VUR utility was not significantly affected by the presence or type of TTO warm-up scenario (p=0.17). CONCLUSIONS TTO perspective affects utilities when estimated via an online interface, however, utilities are unaffected by the presence, type, or absence of warm-up scenarios. These findings could have significant methodological implications for future utility elicitations in other pediatric conditions.

show abstract

Section: Discussionmentioning

confidence: 99%

Utility Estimation for Pediatric Vesicoureteral Reflux: Methodological Considerations Using an Online Survey Platform

et al. 2017

View full text Add to dashboard Cite

show abstract

“…The finding that the decision between ECT and ICT mostly hinges on the possibility of future surgery is not surprising. A recent study sampling parents of pediatric otolaryngology patients indicated that avoidance of possible future salvage surgery was key factor driving their potential choice of ECT versus ICT 19 . This finding is key especially for younger patients, as age at first procedure was significantly associated with risk of regrowth and repeat operation, with younger patients having higher risk 3 …”

Section: Discussionmentioning

confidence: 99%

Comparison of Pediatric Intracapsular Tonsillectomy and Extracapsular Tonsillectomy: A Cost and Utility Decision Analysis

Baik

Brietzke

2018

Otolaryngol.--head neck surg.

Self Cite

View full text Add to dashboard Cite

Objectives To use decision analysis modeling to compare utility and cost outcomes of intracapsular tonsillectomy (ICT) and extracapsular tonsillectomy (ECT). To use sensitivity analysis to determine the most important factors influencing outcomes favoring one surgical method versus another. Study Design Decision analysis model. Setting Hypothetical cohort. Subjects and Methods A decision analysis model was created with computer software comparing the results of ICT and ECT. The model featured complications with completion tonsillectomy, such as postsurgical bleed, dehydration, and tonsillar regrowth. Outcomes were quantified with a utility scale ranging from 0.95 (1 surgical procedure without complications) to 0.55 (ICT, regrowth requiring completion ECT, post-ECT bleeding). Costs measured out-of-pocket costs for an insured patient and factored in different recovery times for ECT versus ICT. Results Based on baseline parameters, ECT had higher cumulative utility than ICT. Utility model results were highly dependent on the value of having a single uncomplicated surgery, as well as on the tonsillar regrowth rate. Utility was equal at a regrowth rate of 1.64%; rates above this value favored ECT. The base cost model showed that ICT ($4177.92) was less expensive than ECT ($4546.91), although ICT with regrowth had the highest outcome cost ($8393.91). ECT and ICT costs were equal at a tonsil regrowth rate of 17.8% and at a recovery period of 7.4 days. Conclusion Utility decision modeling based on best estimates for baseline parameters suggests that ECT may be slightly superior to ICT, but cost analysis suggests the opposite. However, the comparative results are highly dependent on subtle changes in the tonsil regrowth rate and the potential difference in recovery time.

show abstract

Rethinking surgical technique and priorities for pediatric tonsillectomy

Rubinstein

Derkay

2017

American Journal of Otolaryngology

View full text Add to dashboard Cite

Tonsillectomy versus tonsillotomy: A study of parental preference

Cited by 5 publications

References 13 publications

Utility Estimation for Pediatric Vesicoureteral Reflux: Methodological Considerations Using an Online Survey Platform

Utility Estimation for Pediatric Vesicoureteral Reflux: Methodological Considerations Using an Online Survey Platform

Comparison of Pediatric Intracapsular Tonsillectomy and Extracapsular Tonsillectomy: A Cost and Utility Decision Analysis

Rethinking surgical technique and priorities for pediatric tonsillectomy

Contact Info

Product

Resources

About