Impact of Clinical Practice Guidelines on Pediatric Tonsillectomy for Tonsillitis.

IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY
Otolaryngology- Head and Neck Surgery Pub Date : 2024-12-01 Epub Date: 2024-07-21 DOI:10.1002/ohn.914
Avivah J Wang, Jeffrey Cheng
{"title":"Impact of Clinical Practice Guidelines on Pediatric Tonsillectomy for Tonsillitis.","authors":"Avivah J Wang, Jeffrey Cheng","doi":"10.1002/ohn.914","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>To determine the impact of the release of updated American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNSF) Clinical Practice Guidelines (CPG) for Tonsillectomy in Children in 2019 on adherence to evidence-based practice.</p><p><strong>Methods: </strong>Patients between ages 1 and 18 who had tonsillectomies and encounters for throat infection (tonsillitis or pharyngitis) between of February 5, 2015 and February 4, 2023 were identified by International Classification of Diseases and Current Procedural Terminology codes, excluding those with obstructive sleep-disordered breathing. Retrospective chart review was performed to determine adherence to evidence-based practice.</p><p><strong>Results: </strong>There was a significant increase in adherence to evidence-based practice post-CPG release compared to pre-CPG (85.4% vs 73.1%, P = .0088). There was an observed trend for improved adherence to evidence-based practice for pediatric tonsillectomy for recurrent infection for most of the post-CPG period. There were fewer tonsillectomies performed post-CPG, despite more total encounters for throat infection.</p><p><strong>Discussion: </strong>The publication of the updated AAO-HNSF CPG corresponded with improved adherence to evidence-based practice for tonsillectomy in children for recurrent infection and an observed decrease in overall rate of tonsillectomy. This suggests the CPG may be an effective quality improvement tool for reducing variation and unnecessary patient morbidity or harm.</p><p><strong>Implications for practice: </strong>These findings suggest that the updated AAO-HNSF CPG for Tonsillectomy in Children may have effectively impacted practice patterns, and further work should be done to expand their reach to other specialties and settings. Consideration should also be given to further understand any balancing factors associated with reduced tonsillectomies for recurrent infections including quality of life impact on children managed expectantly.</p>","PeriodicalId":19707,"journal":{"name":"Otolaryngology- Head and Neck Surgery","volume":" ","pages":"1949-1955"},"PeriodicalIF":2.6000,"publicationDate":"2024-12-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Otolaryngology- Head and Neck Surgery","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1002/ohn.914","RegionNum":3,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2024/7/21 0:00:00","PubModel":"Epub","JCR":"Q1","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
引用次数: 0

Abstract

Objective: To determine the impact of the release of updated American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNSF) Clinical Practice Guidelines (CPG) for Tonsillectomy in Children in 2019 on adherence to evidence-based practice.

Methods: Patients between ages 1 and 18 who had tonsillectomies and encounters for throat infection (tonsillitis or pharyngitis) between of February 5, 2015 and February 4, 2023 were identified by International Classification of Diseases and Current Procedural Terminology codes, excluding those with obstructive sleep-disordered breathing. Retrospective chart review was performed to determine adherence to evidence-based practice.

Results: There was a significant increase in adherence to evidence-based practice post-CPG release compared to pre-CPG (85.4% vs 73.1%, P = .0088). There was an observed trend for improved adherence to evidence-based practice for pediatric tonsillectomy for recurrent infection for most of the post-CPG period. There were fewer tonsillectomies performed post-CPG, despite more total encounters for throat infection.

Discussion: The publication of the updated AAO-HNSF CPG corresponded with improved adherence to evidence-based practice for tonsillectomy in children for recurrent infection and an observed decrease in overall rate of tonsillectomy. This suggests the CPG may be an effective quality improvement tool for reducing variation and unnecessary patient morbidity or harm.

Implications for practice: These findings suggest that the updated AAO-HNSF CPG for Tonsillectomy in Children may have effectively impacted practice patterns, and further work should be done to expand their reach to other specialties and settings. Consideration should also be given to further understand any balancing factors associated with reduced tonsillectomies for recurrent infections including quality of life impact on children managed expectantly.

临床实践指南对扁桃体炎小儿扁桃体切除术的影响。
目的目的:确定美国耳鼻咽喉头颈外科学会(AAO-HNSF)2019 年发布的最新《儿童扁桃体切除术临床实践指南》(CPG)对循证实践遵守情况的影响:根据《国际疾病分类》和《当前程序术语》代码,对2015年2月5日至2023年2月4日期间因咽喉感染(扁桃体炎或咽炎)而进行扁桃体切除术和就诊的1至18岁患者进行识别,不包括患有阻塞性睡眠呼吸障碍的患者。对病历进行了回顾性审查,以确定对循证实践的遵守情况:结果:与发布《循证指南》前相比,发布《循证指南》后坚持循证实践的比例明显增加(85.4% vs 73.1%,P = .0088)。在《指南》发布后的大部分时间里,小儿扁桃体切除术治疗复发性感染的循证实践依从性呈改善趋势。尽管咽喉感染的总就诊人次增加了,但CPG后实施的扁桃体切除术却减少了:讨论:AAO-HNSF CPG 更新版发布后,儿童扁桃体切除术治疗复发性感染的循证实践得到了改善,扁桃体切除术的总体比例也有所下降。这表明 CPG 可能是一种有效的质量改进工具,可减少变异和不必要的患者发病率或伤害:这些研究结果表明,更新后的 AAO-HNSF 儿童扁桃体切除术 CPG 可能有效地影响了实践模式,应进一步努力将其推广到其他专科和环境中。还应考虑进一步了解与减少复发性感染扁桃体切除术相关的平衡因素,包括对预期治疗儿童生活质量的影响。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
求助全文
约1分钟内获得全文 求助全文
来源期刊
Otolaryngology- Head and Neck Surgery
Otolaryngology- Head and Neck Surgery 医学-耳鼻喉科学
CiteScore
6.70
自引率
2.90%
发文量
250
审稿时长
2-4 weeks
期刊介绍: Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.
×
引用
GB/T 7714-2015
复制
MLA
复制
APA
复制
导出至
BibTeX EndNote RefMan NoteFirst NoteExpress
×
提示
您的信息不完整,为了账户安全,请先补充。
现在去补充
×
提示
您因"违规操作"
具体请查看互助需知
我知道了
×
提示
确定
请完成安全验证×
copy
已复制链接
快去分享给好友吧!
我知道了
右上角分享
点击右上角分享
0
联系我们:info@booksci.cn Book学术提供免费学术资源搜索服务,方便国内外学者检索中英文文献。致力于提供最便捷和优质的服务体验。 Copyright © 2023 布克学术 All rights reserved.
京ICP备2023020795号-1
ghs 京公网安备 11010802042870号
Book学术文献互助
Book学术文献互助群
群 号:481959085
Book学术官方微信