University of Oulu

Laajala, A., Autio, T.J., Ohtonen, P. et al. Interpretation of Tonsillectomy Outcome Inventory-14 scores: a prospective matched cohort study. Eur Arch Otorhinolaryngol 277, 1499–1505 (2020).

Interpretation of Tonsillectomy Outcome Inventory-14 scores : a prospective matched cohort study

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Author: Laajala, Aleksi1,2,3; Autio, Timo J.1,2,3; Ohtonen, Pasi4;
Organizations: 1Department of Otorhinolaryngology and Head and Neck Surgery, Oulu University Hospital, P.O. Box 5000, 90014, Oulu, Finland
2PEDEGO Research Unit, University of Oulu, Oulu, Finland
3Medical Research Center Oulu, Oulu, Finland
4Division of Operative Care, Oulu University Hospital, Oulu, Finland
Format: article
Version: published version
Access: open
Online Access: PDF Full Text (PDF, 0.6 MB)
Persistent link:
Language: English
Published: Springer Nature, 2020
Publish Date: 2020-05-28


Purpose: Knowledge of disease-specific instruments enables the evaluation of health- related quality-of-life (QoL) change associated with chronic and recurrent tonsillitis in adults. The main objective was to explore the interpretation of scores according to the throat-related QoL instrument, Tonsillectomy Outcome Inventory-14 (TOI-14), by determining the typical scores in healthy subjects and patients and define the minimum important change (MIC).

Methods: We performed a prospective matched cohort study in a secondary care area of Oulu University Hospital. The surgical cohort consisted of 42 patients referred to tonsillectomy due to recurrent or chronic tonsillitis. The control cohort consisted of 42 age- and sex-matched healthy controls obtained from the escorts of patients in the same hospital. We translated and validated the Finnish TOI-14 instrument and collected TOI-14 scores at entry and at 6 months and compared results to the anchor question.

Results: At entry, the mean TOI-14 scores were significantly higher in the surgical cohort than in the control cohort [mean (95% confidence interval)] 33.0 (27.0–39.1) vs. 5.0 (3.6–6.4), respectively. At 6 months follow-up, the mean TOI-14 scores had improved markedly after tonsillectomy to the level of the control cohort. In the healthy population, the score was in most cases under 15.0 points. In patients, a score of about 20.0 indicated mild symptoms, 30.0 moderate symptoms and 40.0 or higher intense symptoms. The MIC value was 10.0 points.

Conclusions: These results enable the more accurate interpretation of the scores of the only disease-specific QoL instrument for adult throat-related diseases.

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Series: European archives of oto-rhino-laryngology
ISSN: 0937-4477
ISSN-E: 1434-4726
ISSN-L: 0937-4477
Volume: 277
Pages: 1499 - 1505
DOI: 10.1007/s00405-020-05832-z
Type of Publication: A1 Journal article – refereed
Field of Science: 3125 Otorhinolaryngology, ophthalmology
Funding: Open access funding provided by University of Oulu including Oulu University Hospital.
Copyright information: © The Author(s) 2020. Open Access. This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article's Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article's Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit