{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T05:52:08Z","timestamp":1773035528437,"version":"3.50.1"},"reference-count":20,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2026,2,18]],"date-time":"2026-02-18T00:00:00Z","timestamp":1771372800000},"content-version":"vor","delay-in-days":17,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2026,2,1]],"date-time":"2026-02-01T00:00:00Z","timestamp":1769904000000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Laryngoscope Investig Oto"],"published-print":{"date-parts":[[2026,2]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Purpose<\/jats:title>\n                    <jats:p>To translate, culturally adapt, and validate a Swedish version of the Tonsillectomy Outcome Inventory\u201014 (TOI\u201014) and to evaluate an extended version including three additional sleep\u2010disordered breathing (SDB) items (TOI\u201017) among adult tonsil surgery patients.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This prospective multicenter study was conducted across five Swedish ENT departments between 2022 and 2023. One\u2010hundred\u2010and\u2010eight adults scheduled for tonsil surgery and 84 controls without tonsil disease completed the TOI\u201014, TOI\u201017, and EQ\u20105D VAS at baseline and 2\u2009weeks later, and patients repeated the questionnaires 6\u2009months after surgery. Psychometric evaluation included internal consistency, test\u2013retest reliability, convergent and known\u2010groups validity, responsiveness, confirmatory factor analysis (CFA) and exploratory factor analysis (EFA).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      At baseline, patients reported markedly higher TOI\u201014 (39.5\u2009\u00b1\u200917.8) and TOI\u201017 (50.7\u2009\u00b1\u200919.8) scores than controls (3.9\u2009\u00b1\u20094.5 and 4.9\u2009\u00b1\u20095.0;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). Both instruments showed excellent internal consistency (\n                      <jats:italic>\u03b1<\/jats:italic>\n                      \u2009=\u20090.88 and 0.82) and high test\u2013retest reliability (ICC\u2009=\u20090.89 and 0.83). Scores correlated with EQ\u20105D VAS (\n                      <jats:italic>r<\/jats:italic>\n                      \u2009=\u2009\u22120.54 and \u22120.55;\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001) and improved significantly 6\u2009months postoperatively (\n                      <jats:italic>p<\/jats:italic>\n                      \u2009&lt;\u20090.001). The CFA of the Swedish TOI\u201014 showed suboptimal fit of the original four\u2010factor model, while EFA of the TOI\u201017 supported a five\u2010factor solution, with the three SDB items forming a distinct, internally coherent domain (loadings 0.6\u20130.8).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>The Swedish TOI\u201014 and TOI\u201017 are valid, reliable, and responsive patient\u2010reported outcome measures for adults with tonsil disease. The extended TOI\u201017 version adds clinically relevant coverage of sleep\u2010related symptoms, enhancing applicability for both clinical use and registry\u2010based quality assessment.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Level of Evidence<\/jats:title>\n                    <jats:p>III\u2014non\u2010randomized controlled cohort.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/lio2.70359","type":"journal-article","created":{"date-parts":[[2026,2,19]],"date-time":"2026-02-19T04:09:29Z","timestamp":1771474169000},"update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Validation and Clinical Adaptation of a Swedish Version of the Tonsil Outcome Inventory\u201014 Questionnaire"],"prefix":"10.1002","volume":"11","author":[{"ORCID":"https:\/\/orcid.org\/0009-0007-3260-7711","authenticated-orcid":false,"given":"Andrea","family":"Cvjetkovic","sequence":"first","affiliation":[{"name":"Department of Otorhinolaryngology\u2014Head and Neck Surgery Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg  Gothenburg Sweden"},{"name":"Department of Otorhinolaryngology\u2014Head and Neck Surgery Sahlgrenska University Hospital  Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0009-0008-5110-9344","authenticated-orcid":false,"given":"Hanna","family":"Gerhardsson","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology J\u00f6nk\u00f6ping County Hospital  J\u00f6nk\u00f6ping Sweden"},{"name":"Department of Biomedical and Clinical Sciences Link\u00f6ping University  Link\u00f6ping Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0433-0619","authenticated-orcid":false,"given":"Anders","family":"Brostr\u00f6m","sequence":"additional","affiliation":[{"name":"Department of Nursing, School of Health and Welfare J\u00f6nk\u00f6ping University  J\u00f6nk\u00f6ping Sweden"},{"name":"Department of Clinical Neurophysiology University Hospital Link\u00f6ping  Link\u00f6ping Sweden"},{"name":"Department of Health and Caring Sciences Western Norway University of Applied Sciences  Bergen Norway"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4718-3361","authenticated-orcid":false,"given":"Fredrik","family":"Alm","sequence":"additional","affiliation":[{"name":"School of Health Sciences Faculty of Medicine and Health, \u00d6rebro University  \u00d6rebro Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6854-5248","authenticated-orcid":false,"given":"Erik","family":"Odhagen","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2014Head and Neck Surgery Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg  Gothenburg Sweden"},{"name":"Department of Otorhinolaryngology S\u00f6dra \u00c4lvsborgs Hospital  Bor\u00e5s Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5406-9578","authenticated-orcid":false,"given":"Pia","family":"Nerfeldt","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Karolinska University Hospital  Stockholm Sweden"},{"name":"Department of Clinical Science, Intervention and Technology (CLINTEC) Karolinska Institutet  Stockholm Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Axelsson","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology Helsingborg Hospital  Helsingborg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1192-0182","authenticated-orcid":false,"given":"Ola","family":"Sunnergren","sequence":"additional","affiliation":[{"name":"Department of Otorhinolaryngology\u2014Head and Neck Surgery Institute of Clinical Sciences, Sahlgrenska Academy, University of Gothenburg  Gothenburg Sweden"},{"name":"Department of Otorhinolaryngology\u2014Head and Neck Surgery Sahlgrenska University Hospital  Gothenburg Sweden"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2026,2,18]]},"reference":[{"key":"e_1_2_10_2_1","volume-title":"StatPearls [Internet]","author":"Bohr C.","year":"2025"},{"key":"e_1_2_10_3_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016489.2017.1327122"},{"key":"e_1_2_10_4_1","doi-asserted-by":"publisher","DOI":"10.1002\/lary.5541121404"},{"key":"e_1_2_10_5_1","doi-asserted-by":"publisher","DOI":"10.3122\/jabfm.2020.06.200038"},{"key":"e_1_2_10_6_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen\u20102021\u2010056551"},{"key":"e_1_2_10_7_1","doi-asserted-by":"publisher","DOI":"10.1097\/SLA.0000000000005029"},{"key":"e_1_2_10_8_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016489.2020.1746396"},{"key":"e_1_2_10_9_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00106\u2010012\u20102545\u20107"},{"key":"e_1_2_10_10_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405\u2010020\u201006345\u20103"},{"key":"e_1_2_10_11_1","volume-title":"The Swedish Quality Register for Tonsil Surgery (SQTS): A Description of the Structure and Data Collection","author":"Sunnergren O.","year":"2023"},{"key":"e_1_2_10_12_1","doi-asserted-by":"crossref","DOI":"10.1007\/978-3-030-47622-9_1","volume-title":"An Introduction to EQ\u20105D Instruments and Their Applications","author":"Devlin N.","year":"2020"},{"key":"e_1_2_10_13_1","doi-asserted-by":"publisher","DOI":"10.1186\/s41687\u2010020\u201000230\u20108"},{"key":"e_1_2_10_14_1","doi-asserted-by":"publisher","DOI":"10.1007\/s11136\u2010024\u201003761\u20106"},{"key":"e_1_2_10_15_1","doi-asserted-by":"publisher","DOI":"10.1097\/00006199\u2010200201000\u201000009"},{"key":"e_1_2_10_16_1","doi-asserted-by":"publisher","DOI":"10.5116\/ijme.4dfb.8dfd"},{"key":"e_1_2_10_17_1","volume-title":"Confirmatory Factor Analysis for Applied Research","author":"Brown T. A.","year":"2015"},{"key":"e_1_2_10_18_1","doi-asserted-by":"publisher","DOI":"10.1080\/10705519909540118"},{"key":"e_1_2_10_19_1","doi-asserted-by":"publisher","DOI":"10.9734\/aapmath\/2022\/v27i130063"},{"key":"e_1_2_10_20_1","doi-asserted-by":"publisher","DOI":"10.1080\/00016489.2023.2225555"},{"key":"e_1_2_10_21_1","unstructured":"Swedish National System for Knowledge\u2010Based Healthcare \u201cNational Care Program for the Treatment of Obstructive Sleep Apnea in Adults. National Program Area for Lung and Allergy Diseases \u201d2021 https:\/\/d2flujgsl7escs.cloudfront.net\/external\/nationellt\u2010vardprogram\u2010for\u2010behandling\u2010av\u2010obstruktiv\u2010somnapne\u2010hos\u2010vuxna.pdf."}],"container-title":["Laryngoscope Investigative Otolaryngology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lio2.70359","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1002\/lio2.70359","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lio2.70359","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,3,9]],"date-time":"2026-03-09T04:54:16Z","timestamp":1773032056000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lio2.70359"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,2]]},"references-count":20,"journal-issue":{"issue":"1","published-print":{"date-parts":[[2026,2]]}},"alternative-id":["10.1002\/lio2.70359"],"URL":"https:\/\/doi.org\/10.1002\/lio2.70359","archive":["Portico"],"relation":{},"ISSN":["2378-8038","2378-8038"],"issn-type":[{"value":"2378-8038","type":"print"},{"value":"2378-8038","type":"electronic"}],"subject":[],"published":{"date-parts":[[2026,2]]},"assertion":[{"value":"2025-11-17","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-08","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2026-02-18","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}],"article-number":"e70359"}}