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The 14-item Paediatric Throat Disorders Outcome Test: a valid, sensitive, reliable, parent-reported outcome measure for paediatric throat disorders

Published online by Cambridge University Press:  06 January 2010

C Hopkins ,
J Fairley ,
M Yung ,
I Hore ,
S Balasubramaniam  and
M Haggard
C Hopkins*
Affiliation:
ENT Department of Guy's andSt Thomas' Hospital, London, UK
J Fairley
Affiliation:
ENT Department, William Harvey Hospital, Ashford, UK
M Yung
Affiliation:
ENT Department, Ipswich Hospital, UK
I Hore
Affiliation:
ENT Department of Guy's andSt Thomas' Hospital, London, UK
S Balasubramaniam
Affiliation:
ENT Department, William Harvey Hospital, Ashford, UK
M Haggard
Affiliation:
Department of Experimental Psychology, University of Cambridge, UK
*
Address for correspondence: Ms Claire Hopkins, Carmay, Chelsfield Lane, Orpington BR6 7RR, UK. E-mail: [email protected]
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Abstract

Objectives:

We modified and abbreviated a pre-existing research questionnaire, the Tonsil and Adenoid Health Status Instrument, to make it suitable for rapid completion as a disease-specific, health-related quality of life research tool for children with tonsil and adenoid disease in the UK. We determined the main psychometric properties of the resulting 14-item Paediatric Throat Disorders Outcome Test.

Design, setting and participants:

Pre- and post-operative questionnaires were completed by the parents of children with throat disorders referred to two large hospitals. We included children with recurrent tonsillitis and with obstructive sleep apnoea. A separate cohort of healthy children of comparable age range was also studied.

Main outcome measures:

The test's internal consistency and responsiveness were analysed and its construct validity documented via known-group differences.

Results:

A total of 126 completed questionnaires were received from the hospital referral group. The children's mean age was 6.5 years (range one to 16). The 40 unaffected children were well matched in age to the study population (mean 6.1 years, range two to 15). Cronbach's α coefficient for the pre-operative assessment total score was 0.84. The test–retest reliability coefficient for the total score was 0.98, indicating very high reproducibility. The 14-item Paediatric Throat Disorders Outcome Test discriminated well between children known to suffer with throat problems and a group of healthy controls (p < 0.0001; t = 24.016). Six months after surgical intervention, parentally reported questionnaire scores had improved (i.e. were lower) (p < 0.0001; t = 7.01). The standard effect size (i.e. change in mean divided by baseline standard deviation) for children for whom post-operative questionnaires were completed was 1.53; this is very large.

Conclusions:

The 14-item Paediatric Throat Disorders Outcome Test is an appropriate, disease-specific, parent-reported outcome measure for children with throat disorders, for which we have demonstrated internal consistency, reliability, responsiveness to change and two forms of construct validity.

Keywords

Outcomes AssessmentPatient OutcomesTonsillitisTonsillectomy
Type
Main Article
Information
The Journal of Laryngology & Otology , Volume 124 , Issue 3 , March 2010 , pp. 306 - 314
Copyright
Copyright © JLO (1984) Limited 2009

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References

1Darzi, A. High Quality Care for All: NHS Next Stage Review, Final Report. London: Department of Health, 2008Google Scholar
2Timmins, N. NHS goes to the PROMs. BMJ 2008;336:1464–5CrossRefGoogle Scholar
3Little, P, Williamson, I. Sore throat management in general practice. Fam Pract 1996:13;317–21CrossRefGoogle ScholarPubMed
4 Main operations: 4 character tables. http://www.hesonline.nhs.uk [13 March 2009]Google Scholar
5Blair, RL, McKerrow, WS, Carter, NW, Fenton, A. The Scottish Tonsillectomy Audit. Dundee: JLO, 1996;110:1–25Google ScholarPubMed
6White, C. Chief Medical Officer calls for rewards to improve clinical practice. BMJ 2006;333:216CrossRefGoogle ScholarPubMed
7Stewart, MG, Friedman, E, Sulek, M, Hulka, GF, Kuppersmith, RB, Harrill, WC et al. Quality of life and health status in pediatric tonsil and adenoid disease Arch Otolaryngol Head Neck Surg 2000;126:45–8CrossRefGoogle ScholarPubMed
8Paradise, JL, Bluestone, CD, Bachman, RZ, Colborn, DK, Bernard, BS, Taylor, FH et al. Efficacy of tonsillectomy for recurrent throat infection in severely affected children. Results of parallel randomized and nonrandomized clinical trials. N Eng J Med 1984;310:674–83CrossRefGoogle ScholarPubMed
9McKee, WJ. A controlled study of the effects of tonsillectomy and adenoidectomy in children. J Br Soc Prev Med 1963;17:49–69Google Scholar
10Mawson, SR, Adlington, P, Evans, M. A controlled study evaluation of adeno-tonsillectomy in children. J Laryngol Otol 1967;81:777–90CrossRefGoogle ScholarPubMed
11Roydhouse, N. A controlled study of adenotonsillectomy. Arch Otolaryngol 1970;92:611–16CrossRefGoogle ScholarPubMed
12Burton, MJ, Glasziou, PP. Tonsillectomy or adeno-tonsillectomy versus non-surgical treatment for chronic/recurrent acute tonsillitis. Cochrane Database Syst Rev 2008;4:1291–1326Google Scholar
13Schwentner, I, Schmutzhard, J, Schwentner, C, Abraham, I, Höfer, S, Sprinzl, GM. The impact of adenotonsillectomy on children's quality of life. Clin Otolaryngol 2008;33:56–9CrossRefGoogle ScholarPubMed
14Goldstein, NA, Stewart, MG, Witsell, DL, Hannley, MT, Weaver, EM, Yueh, B et al. Quality of life outcomes after tonsillectomy – results from the TO TREAT study. Otolaryngol Head Neck Surg 2005;133:109–10Google Scholar
15Bond, J, Wilson, J, Eccles, M, Vanoli, A, Steen, N, Clarke, R et al. Protocol for north of England and Scotland study for tonsillectomy and adeno-tonsillectomy in children (NESSTAC). BMC - Ear, Nose and Throat Disorders, Biomed Central 2006;6:13Google Scholar
16National Prospective Tonsillectomy Audit. Royal College of Surgeons of England. 2005. London. ISBN 1-904096-02-06Google Scholar
17Stewart, M, Friedman, E, Sulek, M. Validation of an outcomes instrument for tonsil and adenoid disease. Arch Otolaryngol Head Neck Surg 2001;127:29–35CrossRefGoogle ScholarPubMed
18Patrick, DL, Deyo, RA. Generic and disease-specific measures in assessing health status and quality of life. Med Care 1989;27:S217–32CrossRefGoogle ScholarPubMed
19Management of Sore Throat and Indications for Tonsillectomy SIGN Publication No. 34. 1999Google Scholar
20Guyatt, GH, Norman, GR. A critical look at transition ratings. J Clin Epidemiol 2002;55:900–8CrossRefGoogle Scholar
21Ware, JE, Kosinski, M, Dewey, JE. How to Score Version of SF-36 Health Survey. Lincoln, Rhode Island: QualityMetric Incorporate, 2000Google Scholar
22Roth, PL, Switzer, FS 3rd, Switzer, D. Missing data in multi-item scales: a Monte Carlo analysis of missing data techniques. Organizational Research Methods 1999;2:211–32CrossRefGoogle Scholar
23Cronbach, LJ. Coefficient alpha and the internal structure of tests. Psychometrika 1951;16:297–306CrossRefGoogle Scholar
24Cohen, J. Statistical Power Analysis for the Behavioral Sciences, 2nd edn. New Jersey: Lawrence Erlbaum, 1988Google Scholar
25Levi, RB, Drotar, D. Health-related quality of life in childhood cancer: discrepancy in parent–child reports. Int J Cancer 1999;12:58–643.0.CO;2-A>CrossRefGoogle ScholarPubMed