Normative tonsillectomy outcome inventory 14 values as a decision-making tool for tonsillectomy
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Normative tonsillectomy outcome inventory 14 values as a decision‑making tool for tonsillectomy Michaela Plath1 · Matthias Sand2 · Philippe A. Federspil1 · Peter K. Plinkert1 · Ingo Baumann1 · Karim Zaoui1 Received: 5 August 2020 / Accepted: 12 September 2020 © The Author(s) 2020
Abstract Purpose The study aimed to determine normative values for the Tonsillectomy Outcome Inventory 14 (TOI-14) in a healthy middle-European cohort. We also compared these generated values with TOI-14 scores from a patient population with recurrent tonsillitis (RT) and explored the factorial structure of the TOI-14. Methods We systematically studied the responses of healthy individuals (reference cohort) and patients with RT (clinical cohort) to the TOI-14 survey. The reference cohort contained 1000 participants, who were recruited using the Respondi panel for market and social science research. This subsample was quoted to the population distribution of the German Microcensus and selected from a non-probability panel. Tonsillitis patients were assessed before and 6 and 12 months after tonsillectomy. Data were analysed using principal component and exploratory factor analyses. Results The PCA revealed three TOI-14 domains (physiological, psychological and socio-economic), which explained 73% of the total variance. The reference cohort perceived a good quality of life (QOL) with a TOI-14 total score of 11.8 (physiological: 8.0, psychological: 5.8, and socio-economic subscale score: 13.9). TOI-14 scores were higher in the patient cohort, indicating that the TOI-14 discriminates between patients with RT and healthy individuals with no RT. Age and female gender significantly influenced the total TOI-14 score, especially in the psychological (age) and socio-economic (gender) subscales. Conclusion We have developed a set of normative values that, together with the TOI-14, can determine the disease burden indicating tonsillectomy. Keywords TOI-14 · Quality of life · Recurrent tonsillitis · Guidelines · PCA · EFA · Middle-european cohort
Introduction Tonsillectomy is one of the most common surgical interventions [1, 2]. The main indications for tonsillectomy are recurrent infections, suspicion of malignant disease, and grade four tonsillar hypertrophy (kissing tonsil) with obstructive sleep apnoea [3]. Recurrent tonsillitis (RT) reduces the disease-specific quality of life (QOL) [2]. The effectiveness of tonsillectomy as a treatment for RT in adults is controversial. Previous studies have shown that tonsillectomy is associated * Karim Zaoui [email protected]‑heidelberg.de 1
Department of Otorhinolaryngology, Head and Neck Surgery, University Hospital Heidelberg, Ruprecht-KarlsUniversity, Im Neuenheimer Feld 400, 69120 Heidelberg, Germany
GESIS-Leibniz-Institute for the Social Sciences, Mannheim, Germany
2
with improved health-related quality of life (HR-QOL) [1, 2, 4, 5], reduced medication consumption, less time off work, and fewer visits to the physician [6]. In another study, 75% of tonsillectomies for RT r
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