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- Title
Immediate adenoidectomy vs initial watchful waiting strategy in children with recurrent upper respiratory tract infections: an economic evaluation.
- Authors
Boonacker, Chantal W B; van den Aardweg, Maaike T A; Broos, Pieter H; Hoes, Arno W; Schilder, Anne G M; Rovers, Maroeska M
- Abstract
<bold>Objective: </bold>To compare the costs associated with 2 clinical strategies in children with recurrent upper respiratory tract infections (URTIs): immediate adenoidectomy vs an initial watchful waiting strategy.<bold>Design: </bold>A cost-minimization analysis from a societal perspective including both direct and indirect costs, alongside an open randomized controlled trial with a 2-year follow-up.<bold>Setting: </bold>Multicenter study, including 11 general and 2 university hospitals in the Netherlands.<bold>Patients: </bold>The study population comprised 111 children aged 1 through 6 years, selected for adenoidectomy for recurrent URTIs according to current clinical practice.<bold>Intervention: </bold>A strategy of immediate adenoidectomy with or without myringotomy or a strategy of initial watchful waiting.<bold>Main Outcomes Measures: </bold>Difference in median costs during the 2-year follow-up.<bold>Results: </bold>The median total of direct and indirect costs in the adenoidectomy and watchful waiting group were €1385 (US $1995) and €844 (US $1216) per patient, respectively. The extra costs in the adenoidectomy group are primarily attributable to surgery and visits to the otorhinolaryngologist. Other costs did not differ significantly between the groups.<bold>Conclusions: </bold>In children selected for adenoidectomy for recurrent URTIs, immediate adenoidectomy results in an increase in costs, whereas it confers no clinical benefit over an initial watchful waiting strategy.<bold>Trial Registration: </bold>trialregister.nl Identifier:NTR968; isrctn.org Identifier:ISRCTN03720485.
- Publication
JAMA Otolaryngology-Head & Neck Surgery, 2013, Vol 139, Issue 2, p129
- ISSN
2168-6181
- Publication type
journal article
- DOI
10.1001/jamaoto.2013.1324