@article {{\v S}umiloe33, author = {Dana {\v S}umilo and Linda Nichols and Ronan Ryan and Tom Marshall}, title = {Incidence of indications for tonsillectomy and frequency of evidence-based surgery: a 12-year retrospective cohort study of primary care electronic records}, volume = {69}, number = {678}, pages = {e33--e41}, year = {2019}, doi = {10.3399/bjgp18X699833}, publisher = {Royal College of General Practitioners}, abstract = {Background Neither the incidence of indications for childhood tonsillectomy nor the proportion of tonsillectomies that are evidence-based is known.Aim To determine the incidence of indications for tonsillectomy in UK children, and the proportion of tonsillectomies meeting evidence-based criteria.Design and setting A retrospective cohort study of electronic medical records of children aged 0{\textendash}15 years registered with 739 UK general practices contributing to a research database.Method Children with recorded indications for tonsillectomy were identified from electronic medical records. Evidence-based indications included documented sore throats of sufficient frequency and severity (Paradise criteria); periodic fever, aphthous stomatitis, pharyngitis, and cervical adenitis syndrome (PFAPA); or tonsillar tumour. Other indications were considered non-evidence-based. The numbers of children subsequently undergoing tonsillectomy was then identified. The numbers with evidence-based and non-evidence-based indications for surgery among children who had undergone tonsillectomy were determined.Results The authors included 1 630 807 children followed up for 7 200 159 person{\textendash}years between 2005 and 2016. Incidence of evidence-based indications for tonsillectomy was 4.2 per 1000 person years; 13.6\% (2144/15 760) underwent tonsillectomy. Incidence of childhood tonsillectomy was 2.5 per 1000 person years; 11.7\% (2144/18 281) had evidence-based indications, almost all with Paradise criteria. The proportion of evidence-based tonsillectomies was unchanged over 12 years. Most childhood tonsillectomies followed non-evidence-based indications: five to six sore throats (12.4\%) in 1 year, two to four sore throats (44.6\%) in 1 year, sleep disordered breathing (12.3\%), or obstructive sleep apnoea (3.9\%).Conclusion In the UK, few children with evidence-based indications undergo tonsillectomy and seven in eight of those who do (32 500 of 37 000 annually) are unlikely to benefit.}, issn = {0960-1643}, URL = {https://bjgp.org/content/69/678/e33}, eprint = {https://bjgp.org/content/69/678/e33.full.pdf}, journal = {British Journal of General Practice} }