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Seven in 8 children's tonsillectomies are unnecessary
Researchers analysed the electronic medical records of over 1.6 million children from more than 700 UK general practices dating between 2005 and 2016. They found that out of 18,271 children who had their tonsils removed during this time, only 2,144 (11.7 per cent) had enough sore throats to justify surgery.
The researchers at the University's Institute of Applied Health Research concluded that their evidence, published today (Nov 6th) in British Journal of General Practice, showed that annually 32,500 children undergo needless tonsillectomies at a cost to the NHS of £36.9 million.
What's more, they found that many children who might benefit from having their tonsils removed are not having the surgical procedure. They found that of 15,764 children who had records showing sufficient sore throats to undergo a tonsillectomy, just 2,144 (13.6 per cent) actually went on to have one.
[...] Tom Marshall, Professor or Public Health and Primary Care at the University of Birmingham, said: "Research shows that children with frequent sore throats usually suffer fewer sore throats over the next year or two. In those children with enough documented sore throats, the improvement is slightly quicker after tonsillectomy, which means surgery is justified.
"But research suggests children with fewer sore throats don't benefit enough to justify surgery, because the sore throats tend to go away anyway.
"Our research showed that most children who had their tonsils removed weren't severely enough affected to justify treatment, while on the other hand, most children who were severely enough affected with frequent sore throats did not have their tonsils removed. The pattern changed little over the 12 year period.
"Children may be more harmed than helped by a tonsillectomy. We found that even among severely affected children only a tiny minority of ever have their tonsils out. It makes you wonder if tonsillectomy ever really essential in any child."
Incidence of indications for tonsillectomy and frequency of evidence-based surgery: a 12-year retrospective cohort study of primary care electronic records (DOI 10.3399/bjgp18X699833$)
(Score: 3, Interesting) by kazzie on Thursday November 08 2018, @05:35AM
This report is from the UK, which moved away from the "fee for service" model to one of "free at point of use" seventy years ago.
The title for the Soylent article's got things a bit wrong. From TFS: of those who had tonsillectomies, only 1 in 10 (11%) had met the guidelines of how many sore throats in a year warrant surgery. Separately, of those who had enough sore throats to meet the guidelines, only 1 in 8 (13.6%) had the operation.
(From TFA: "Current UK health policy, based on the best scientific evidence, is that to meet the criteria to benefit from a tonsillectomy children must suffer from either more than seven documented sore throats in a year; more than five sore throats per year for two successive years; or three sore throats per year for three successive years.")
So of those children suffering from chronic sore throats, 7 out of 8 didn't have a tonsillectomy. (But I bet most of them survived in spite of this.) The ratio of those who had a tonsillectomy unnecessarily is worse than the title used: 9 out of 10 of those are unnecessary!
TLDR: According to our guidelines, we're doing most of our tonsillectomies to the wrong group of people. (Corollary: maybe we don't need to be doing tonsillectomies as often / at all.)