title: 'Thinking that somebody's going to delay [a tonsillectomy] for one to two years is quite horrifying really': a qualitative feasibility study for the NAtional Trial of Tonsillectomy IN Adults (NATTINA Part 2).
abstract: OBJECTIVE
  Level one evidence on the value of adult tonsillectomy versus non-surgical management remains scarce. Before embarking on a costly national randomised controlled trial, it is essential to establish its feasibility.
  
  
  METHODS
  Feasibility study with in-depth qualitative and cognitive interviews.
  
  
  METHODS
  ENT staff and patients were recruited from nine hospital centres across England and Scotland.
  
  
  METHODS
  Patients who were referred for tonsillectomy (n = 15), a convenience sample of general practitioners (n = 11) and ear, nose and throat staff (n = 22).
  
  
  METHODS
  To ascertain whether ear, nose and throat staff would be willing to randomise patients to the treatment arms. To assess general practitioners' willingness to refer patients to the NAtional Trial of Tonsillectomy IN Adults (NATTINA) centres. To assess patients' willingness to be randomised and the acceptability of the deferred surgery treatment arm. To ascertain whether the study could progress to the pilot trial stage.
  
  
  RESULTS
  Ear, nose and throat staff and general practitioners were willing to randomise patients to the proposed NATTINA. Not all ENT staff were in equipoise concerning the treatment pathways. Patients were reluctant to be randomised into the deferred surgery group if they had already waited a substantial time before being referred.
  
  
  CONCLUSIONS
  Findings suggest that the NATTINA may not be feasible. Proposed methods could not be realistically assessed without a pilot trial. Due to the importance of the question, as evidenced by NATTINA clinicians, and strong support from ENT staff, the pilot trial proceeded, with modifications.
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: L A
authors.initials: LA
authors.lastname: McSweeney
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.|ENT Department, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
authors.forename: J T
authors.initials: JT
authors.lastname: O'Hara
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: N S
authors.initials: NS
authors.lastname: Rousseau
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: D D
authors.initials: DD
authors.lastname: Stocken
authors.affiliation: Population Health Sciences, University of Dundee, Dundee, UK.|Department of Community and Family Medicine, University of Toronto, Toronto, ON, Canada.
authors.forename: F
authors.initials: F
authors.lastname: Sullivan
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: L
authors.initials: L
authors.lastname: Vale
authors.affiliation: Department of Pharmacy Health and Well-being, University of Sunderland, Sunderland, UK.|UK Coquet Medical Group, Amble, Northumberland, UK.
authors.forename: S
authors.initials: S
authors.lastname: Wilkes
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.|ENT Department, Freeman Hospital, Newcastle upon Tyne Hospitals NHS Foundation Trust, Newcastle upon Tyne, UK.
authors.forename: J A
authors.initials: JA
authors.lastname: Wilson
authors.affiliation: Institute of Health and Society, Newcastle University, Newcastle upon Tyne, UK.
authors.forename: C A
authors.initials: CA
authors.lastname: Haighton
mesh_terms: D000328:Adult; D002985:Clinical Protocols; D003362:Cost-Benefit Analysis; D003657:Decision Making; D019468:Disease Management; D004739:England / Q000453:epidemiology; D005240:Feasibility Studies; D005260:Female; D006801:Humans; D015994:Incidence; D007407:Interviews as Topic; D008297:Male; D016032:Randomized Controlled Trials as Topic; D012606:Scotland / Q000453:epidemiology; D013997:Time Factors; D061665:Time-to-Treatment / Q000639:trends*; D014068:Tonsillectomy / Q000379:methods; D014069:Tonsillitis / Q000191:economics / Q000453:epidemiology / Q000628:therapy*