title: Variation in practice: an analysis of Scottish Surgical Profiles ENT data.
abstract: BACKGROUND
  Variation in otolaryngology intervention rates is reported in the Scottish Surgical Profiles Project. Tonsillectomy is one of the selected key indicator procedures. The variation in practice was discussed nationally at the Scottish Otolaryngology Society summer meetings in 2009 and 2010. NHS Grampian had a significantly higher tonsillectomy rate compared with other Scottish NHS boards.
  
  
  OBJECTIVE
  To determine the accuracy of NHS Grampian data reported by the Information Service Division (ISD) and to record the appropriateness of listing of patients for tonsillectomy with reference to the Scottish Intercollegiate Guidelines Network (SIGN).
  
  
  METHODS
  Retrospective review of case notes and surgical records of patients who had undergone tonsillectomy between March 2007 and March 2008 in NHS Grampian.
  
  
  RESULTS
  Between March 2007 and March 2008, 509 tonsillectomy cases were performed in NHS Grampian. This corresponded to the data received from ISD. 87% of tonsillectomies performed were compliant with SIGN guidelines.
  
  
  CONCLUSIONS
  The Scottish otolaryngology clinicians have found the reporting of the intervention rates stimulating and challenging. Discussion of the surgical profile project regularly at national specialty meetings resulted in a preliminary detailed targeted audit of those who were persistent outliers for tonsillectomy. This refuted the presumed reasons for this variation, namely inaccurate figures from ISD and inappropriate listings by clinicians.
authors.affiliation: Department of Otolaryngology, Aberdeen Royal Infirmary, UK. justin.yeo@nhs.net
authors.forename: J C L
authors.initials: JC
authors.lastname: Yeo
authors.forename: K W
authors.initials: KW
authors.lastname: Ah-See
authors.forename: K
authors.initials: K
authors.lastname: Mackenzie
mesh_terms: D000293:Adolescent; D000328:Adult; D005260:Female; D006801:Humans; D008297:Male; D010036:Otolaryngology / Q000706:statistics & numerical data*; D012189:Retrospective Studies; D012606:Scotland; D014068:Tonsillectomy / Q000706:statistics & numerical data; D014069:Tonsillitis / Q000601:surgery