{"title":"Piloting of a Decision Aid for Recurrent Tonsillitis.","authors":"Callum Hill, Kim Ah-See, Helen Moffat","doi":"10.1111/coa.14278","DOIUrl":null,"url":null,"abstract":"<p><strong>Objective: </strong>Currently, there is no adult-specific decision aid (DA) to support decision-making regarding recurrent tonsillitis. This study intends to address this gap by piloting a prototype DA.</p><p><strong>Design: </strong>Randomised clinical trial.</p><p><strong>Setting: </strong>Single centre trial at a tertiary otolaryngology department.</p><p><strong>Participants: </strong>Forty-three patients were randomised to either the DA or Treatment as Usual (TAU) group.</p><p><strong>Main outcome measures: </strong>Primary objective: To measure how patients rate the quality of their decision-making experience at the time of the decision and at follow-up (SURE scale).</p><p><strong>Secondary objective: </strong>The level of decisional satisfaction at the time of the decision and follow-up, as well as to explore the numbers of people opting for surgery for each study condition (Shared tool and patient feedback).</p><p><strong>Results: </strong>Quality: This study demonstrates no statistically significant difference in how patients rate the quality of their treatment decision between DA and TAU, both at baseline (p = 0.553) and follow-up (p = 0.062). Satisfaction: This study showed a statistically significant level of decisional satisfaction at the time the decision was made for Qu2 of the Shared tool (U = 113, p = 0.026). No other significant difference was found between participants who received the DA and TAU.</p><p><strong>Conclusion: </strong>The DA is an acceptable and useful tool that could be incorporated into the pathway for recurrent tonsillitis, helping to eliminate physician implicit bias. However, preliminary qualitative evidence from this pilot study does not suggest that including the DA improves the quality of decision-making.</p><p><strong>Trial registration: </strong>IRAS ID - 230 362.</p>","PeriodicalId":10431,"journal":{"name":"Clinical Otolaryngology","volume":" ","pages":""},"PeriodicalIF":1.7000,"publicationDate":"2025-01-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"0","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Clinical Otolaryngology","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1111/coa.14278","RegionNum":4,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q2","JCRName":"OTORHINOLARYNGOLOGY","Score":null,"Total":0}
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Abstract
Objective: Currently, there is no adult-specific decision aid (DA) to support decision-making regarding recurrent tonsillitis. This study intends to address this gap by piloting a prototype DA.
Design: Randomised clinical trial.
Setting: Single centre trial at a tertiary otolaryngology department.
Participants: Forty-three patients were randomised to either the DA or Treatment as Usual (TAU) group.
Main outcome measures: Primary objective: To measure how patients rate the quality of their decision-making experience at the time of the decision and at follow-up (SURE scale).
Secondary objective: The level of decisional satisfaction at the time of the decision and follow-up, as well as to explore the numbers of people opting for surgery for each study condition (Shared tool and patient feedback).
Results: Quality: This study demonstrates no statistically significant difference in how patients rate the quality of their treatment decision between DA and TAU, both at baseline (p = 0.553) and follow-up (p = 0.062). Satisfaction: This study showed a statistically significant level of decisional satisfaction at the time the decision was made for Qu2 of the Shared tool (U = 113, p = 0.026). No other significant difference was found between participants who received the DA and TAU.
Conclusion: The DA is an acceptable and useful tool that could be incorporated into the pathway for recurrent tonsillitis, helping to eliminate physician implicit bias. However, preliminary qualitative evidence from this pilot study does not suggest that including the DA improves the quality of decision-making.
期刊介绍：
Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with:
current otorhinolaryngological practice
audiology, otology, balance, rhinology, larynx, voice and paediatric ORL
head and neck oncology
head and neck plastic and reconstructive surgery
continuing medical education and ORL training
The emphasis is on high quality new work in the clinical field and on fresh, original research.
Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject.
• Negative/null results
In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.
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