{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T13:59:58Z","timestamp":1776347998650,"version":"3.51.2"},"reference-count":22,"publisher":"Wiley","issue":"3","license":[{"start":{"date-parts":[[2016,11,15]],"date-time":"2016-11-15T00:00:00Z","timestamp":1479168000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Clinical Otolaryngology"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To assess the impact of the introduction of the <jats:styled-content style=\"fixed-case\">SIGN<\/jats:styled-content> Clinical guidelines in 1999 and subsequent revision in 2005 on tonsillectomy, hospital admission with tonsillitis and peritonsillar abscess rates in four countries.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Retrospective analysis using English, Welsh, Australian and New Zealand National healthcare hospital admission databases between 2000 and 2013. Primary outcomes measures included tonsillectomy rates and hospital admission rates for tonsillitis and peritonsillar abscess. Secondary outcome measures included bed\u2010day usage in England and Wales. Linear forecasting was used to identify the potential impact of any trends.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Following guideline introduction for tonsillectomy, a significant decline in tonsillectomy rates in England (<jats:italic>P<\/jats:italic> &lt; 0.01) and Wales (<jats:italic>P<\/jats:italic> &lt; 0.05) was seen. Hospital admissions for acute tonsil infections increased in England (<jats:italic>P<\/jats:italic> &lt; 0.01) and Wales (<jats:italic>P<\/jats:italic> &lt; 0.01). In Australia and New Zealand, tonsillectomy and admission for tonsillitis rates both increased (<jats:italic>P<\/jats:italic> &lt; 0.01). During this time, the increased rate of admission for tonsillitis in England and Wales was significantly greater than Australasia (<jats:italic>P<\/jats:italic> &lt; 0.01).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Following the introduction of these Clinical guidelines, there was a decrease in the rate of tonsillectomy in England and Wales and a presumed associated increase in admissions with tonsillitis. This did not occur in Australasia where tonsillectomy rates rose over time. If these trends continue, it is likely that they will have a significant deleterious impact on healthcare spending in the future.<\/jats:p><\/jats:sec>","DOI":"10.1111\/coa.12773","type":"journal-article","created":{"date-parts":[[2016,10,18]],"date-time":"2016-10-18T13:26:45Z","timestamp":1476797205000},"page":"573-577","source":"Crossref","is-referenced-by-count":8,"title":["Tonsillectomy is not a procedure of limited value \u2013 the unseen costs of tonsillitis and quinsy on hospital bed consumption"],"prefix":"10.1111","volume":"42","author":[{"given":"R.","family":"Mcleod","sequence":"first","affiliation":[{"name":"University Hospital of Wales Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1228-5798","authenticated-orcid":false,"given":"P.","family":"Brahmabhatt","sequence":"additional","affiliation":[{"name":"University Hospital of Wales Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"D.","family":"Owens","sequence":"additional","affiliation":[{"name":"University Hospital of Wales Cardiff UK"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2016,11,15]]},"reference":[{"key":"e_1_2_8_2_1","doi-asserted-by":"publisher","DOI":"10.1097\/MLG.0b013e31805559e1"},{"key":"e_1_2_8_3_1","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-012-2095-3"},{"key":"e_1_2_8_4_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.otohns.2006.12.029"},{"key":"e_1_2_8_5_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215107001557"},{"key":"e_1_2_8_6_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.110.1.7"},{"key":"e_1_2_8_7_1","volume-title":"Achieving World Class Productivity in the NHS 2009\/10 \u2013 2013\/14: Detailing the Size of the Opportunity","author":"McKinsey","year":"2009"},{"key":"e_1_2_8_8_1","doi-asserted-by":"publisher","DOI":"10.1001\/archotol.133.11.1083"},{"key":"e_1_2_8_9_1","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215112000643"},{"key":"e_1_2_8_10_1","unstructured":"LawsonH.(2013)NHS should take out more tonsils to avoid repeat cases of sore throats say doctors. 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