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However, the absence of high-level evidence addressing the role of AT in improving health and behavioural outcomes has contributed to significant geographical variations in care and potential for surgery to be both overused and underused.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods and analysis<\/jats:title>\n                  <jats:p>The Pediatric Adenotonsillectomy Trial for Snoring (PATS) is a single-blinded, multicentre randomised controlled trial designed to evaluate the effect of AT in treating mild oSDB. Four hundred sixty eligible children, aged 3.0\u201312.9 years old, will be randomised to either early adenotonsillectomy or to watchful waiting with supportive care (WWSC) with a 1:1 ratio. The study\u2019s coprimary endpoints are (1) change from baseline in executive behaviour relating to self-regulation and organisation skills as measured by the Behavioural Rating Inventory of Executive Function (BRIEF) Global Composite Score (GEC); and (2) change from baseline in vigilance as measured on the Go-No-Go (GNG) signal detection parameter (d-prime). A mixed effects model will be used to compare changes in the BRIEF GEC score and GNG score at 6 and 12 months from baseline between the AT arm and the WWSC arm.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Ethics and dissemination<\/jats:title>\n                  <jats:p>The study protocol was approved by the institutional review board (IRB) at Children\u2019s Hospital of Philadelphia (CHOP) on 3 October 2014 (14\u20130 11 214). The approval of CHOP as the central IRB of record was granted on 29 February 2016. The results will be published in peer-reviewed journals and presented at academic conferences. The data collected from the PATS study will be deposited in a repository (National Sleep Research Resource, sleepdata.org) after completion of the study to maximise use by the scientific community.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Trial registration number<\/jats:title>\n                  <jats:p>\n                     <jats:ext-link xmlns:xlink=\"http:\/\/www.w3.org\/1999\/xlink\" ext-link-type=\"clintrialgov\" specific-use=\"clinicaltrial pre-results\" xlink:href=\"NCT02562040\">NCT02562040<\/jats:ext-link>; Pre-results.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1136\/bmjopen-2019-033889","type":"journal-article","created":{"date-parts":[[2020,3,16]],"date-time":"2020-03-16T05:15:14Z","timestamp":1584335714000},"page":"e033889","update-policy":"https:\/\/doi.org\/10.1136\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":40,"title":["Pediatric Adenotonsillectomy Trial for Snoring (PATS): protocol for a randomised controlled trial to evaluate the effect of adenotonsillectomy in treating mild obstructive sleep-disordered breathing"],"prefix":"10.1136","volume":"10","clinical-trial-number":[{"clinical-trial-number":"nct02562040","registry":"10.18810\/clinical-trials-gov","type":"preResults"}],"author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5007-193X","authenticated-orcid":false,"given":"Rui","family":"Wang","sequence":"first","affiliation":[{"name":"Department of Population Medicine, Harvard Pilgrim Health Care Institute and Harvard Medical School, Boston, Massachusetts, USA"},{"name":"Department of Biostatistics, Harvard University T. 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Chan School of Public Health, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jessie P.","family":"Bakker","sequence":"additional","affiliation":[{"name":"Division of Sleep Medicine and Circadian Disorders, Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald D.","family":"Chervin","sequence":"additional","affiliation":[{"name":"Sleep Disorders Center and Department of Neurology, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Susan L.","family":"Garetz","sequence":"additional","affiliation":[{"name":"Sleep Disorders Center and Department of Otolaryngology-Head and Neck Surgery, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Fauziya","family":"Hassan","sequence":"additional","affiliation":[{"name":"Sleep Disorders Center and Division of Pediatric Pulmonology, University of Michigan, Ann Arbor, Michigan, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey L.","family":"Ishman","sequence":"additional","affiliation":[{"name":"Divisions of Otolaryngology-Head and Neck Surgery and Pulmonary Medicine, Cincinnati Children's Hospital Medical Center, Cincinnati, Ohio, USA"},{"name":"Department of Otolaryngology-Head and Neck Surgery, College of Medicine, University of Cincinnati, Cincinnati, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ron B.","family":"Mitchell","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery, UT Southwestern and Children's Medical Center Dallas, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G.","family":"Morrical","sequence":"additional","affiliation":[{"name":"Division of Sleep Medicine and Circadian Disorders, Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Syed K.","family":"Naqvi","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Head and Neck Surgery, UT Southwestern and Children's Medical Center Dallas, Dallas, Texas, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jerilynn","family":"Radcliffe","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Pennsylvania, Philadelphia, Pennsylvania, USA"},{"name":"Center for Human Phenomic Science, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Emily I.","family":"Riggan","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, Eastern Virginia Medical School, Norfolk, Virginia, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carol L.","family":"Rosen","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University Hospitals Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kristie","family":"Ross","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University Hospitals Rainbow Babies and Children's Hospital, Case Western Reserve University School of Medicine, Cleveland, Ohio, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Rueschman","sequence":"additional","affiliation":[{"name":"Division of Sleep Medicine and Circadian Disorders, Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ignacio E.","family":"Tapia","sequence":"additional","affiliation":[{"name":"Department of Pediatrics, University of Pennsylvania, Philadelphia, Pennsylvania, USA"},{"name":"Division of Pulmonary Medicine, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H. 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