Skip to content

Research at St Andrews

‘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)

Research output: Contribution to journalArticle



L. A. McSweeney, J. T. O'Hara, N. S. Rousseau, D. D. Stocken, F. Sullivan, L. Vale, S. Wilkes, J. A. Wilson, C. A. Haighton

School/Research organisations


Objectives: 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.
Design: Feasibility study with in-depth qualitative and cognitive interviews. Setting: ENT staff and patients were recruited from nine hospital centres across England and Scotland.
Participants: Patients who were referred for tonsillectomy (n = 15), a convenience sample of general practitioners (n = 11) and ear, nose and throat staff (n = 22).
Main outcome measures:
1. To ascertain whether ear, nose and throat staff would be willing to randomise patients to the treatment arms.
2. To assess general practitioners’ willingness to refer patients to the NAtional Trial of Tonsillectomy IN Adults (NATTINA) centres.
3. To assess patients’ willingness to be randomised and the acceptability of the deferred surgery treatment arm.
4. 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.


Original languageEnglish
Pages (from-to)578-583
Number of pages6
JournalClinical Otolaryngology
Issue number3
Early online date10 Nov 2016
Publication statusPublished - Jun 2017

Discover related content
Find related publications, people, projects and more using interactive charts.

View graph of relations

Related by author

  1. Drivers of the opioid crisis: An appraisal of financial conflicts of interest in clinical practice guideline panels at the peak of opioid prescribing

    Spithoff, S., Leece, P., Sullivan, F., Persaud, N., Belesiotis, P. & Steiner, L., 24 Jan 2020, In : PLoS ONE. 15, 1, 15 p., e0227045.

    Research output: Contribution to journalArticle

  2. Trial Forge Guidance 2: how to decide if a further Study Within A Trial (SWAT) is needed

    Treweek, S., Bevan, S., Bower, P., Briel, M., Campbell, M., Christie, J., Collett, C., Cotton, S., Devane, D., El Feky, A., Galvin, S., Gardner, H., Gillies, K., Hood, K., Jansen, J., Littleford, R., Parker, A., Ramsay, C., Restrup, L., Sullivan, F. & 7 others, Torgerson, D., Tremain, L., von Elm, E., Westmore, M., Williams, H., Williamson, P. R. & Clarke, M., 7 Jan 2020, In : Trials. 21, 9 p., 33.

    Research output: Contribution to journalArticle

  3. Effect on treatment adherence of distributing essential medicines at no charge: the CLEAN Meds randomized clinical trial

    Persaud, N., Bedard, M., Boozary, A. S., Glazier, R. H., Gomes, T., Hwang, S. W., Jüni, P., Law, M. R., Mamdani, M. M., Manns, B. J., Martin, D., Morgan, S. G., Oh, P. I., Pinto, A. D., Shah, B. R., Sullivan, F., Umali, N., Thorpe, K. E., Tu, K., Laupacis, A. & 1 others, for the Carefully Selected and Easily Accessible at No Charge Medicines (CLEAN Meds) Study Team, Jan 2020, In : JAMA Internal Medicine. 180, 1, p. 27-34 8 p.

    Research output: Contribution to journalArticle

Related by journal

  1. A mixed methods comparative evaluation of a low cost otoscope (Arclight) with a traditional device in twenty-one clinicians

    Hey, S. Y., Buckley, J. C., Shahsavari, S., Kousha, O., Haddow, K. A., Blaikie, A. & Walker, F. D. L., 6 Aug 2019, In : Clinical Otolaryngology. Early View, 4 p.

    Research output: Contribution to journalArticle

  2. Systematic review of the safety of electrosurgery for tonsillectomy

    Mowatt, G., Cook, J. A., Fraser, C., McKerrow, W. S. & Burr, J. M., Apr 2006, In : Clinical Otolaryngology. 31, 2, p. 95-102 8 p.

    Research output: Contribution to journalReview article

  3. Salvage laryngectomy after radical radiotherapy for laryngeal carcinoma

    MacDougall, R. H., Crellin, R. P., Gaze, M. N., White, A. & Maran, A. G., Oct 1992, In : Clinical Otolaryngology. 17.5, p. 449-451 3 p.

    Research output: Contribution to journalArticle

ID: 262870768