The Glasgow Benefit Inventory: a systematic review of the use and value of an otorhinolaryngological generic patient-recorded outcome measure

The Glasgow Benefit Inventory (GBI) is a validated, generic patient-recorded outcome measure widely used in otolaryngology to report change in quality of life post-intervention.To date, no systematic review has made (i) a quality assessment of reporting of Glasgow Benefit Inventory outcomes; (ii) a comparison between Glasgow Benefit Inventory outcomes for different interventions and objectives; (iii) an evaluation of subscales in describing the area of benefit; (iv) commented on its value in clinical practice and research.Systematic review.'Glasgow Benefit Inventory' and 'GBI' were used as keywords to search for published, unpublished and ongoing trials in PubMed, EMBASE, CINAHL and Google in addition to an ISI citation search for the original validating Glasgow Benefit Inventory paper between 1996 and January 2015.Papers were assessed for study type and quality graded by a predesigned scale, by two authors independently. Papers with sufficient quality Glasgow Benefit Inventory data were identified for statistical comparisons. Papers with 50% and gave sufficient Glasgow Benefit Inventory total and subscales for meta-analysis. For five of the 11 operation categories (vestibular schwannoma, tonsillectomy, cochlear implant, middle ear implant and stapes surgery) that were most likely to have a single clear clinical objective, score data had low-to-moderate heterogeneity. The value in the Glasgow Benefit Inventory having both positive and negative scores was shown by an overall negative score for the management of vestibular schwannoma. The other six operations gave considerable heterogeneity with rhinoplasty and septoplasty giving the greatest percentages (98% and 99%) most likely because of the considerable variations in patient selection. The data from these operations should not be used for comparative purposes. Five papers also reported the number of patients that had no or negative benefit, a potentially a more clinically useful outcome to report. Glasgow Benefit Inventory subscores for tonsillectomy were significantly different from ear surgery suggesting different areas of benefitThe Glasgow Benefit Inventory has been shown to differentiate the benefit between surgical and medical otolaryngology interventions as well as 'reassurance'. Reporting benefit as percentages with negative, no and positive benefit would enable better comparisons between different interventions with varying objectives and pathology. This could also allow easier evaluation of factors that predict benefit. Meta-analysis data are now available for comparison purposes for vestibular schwannoma, tonsillectomy, cochlear implant, middle ear implant and stapes surgery. Fuller report of the Glasgow Benefit Inventory outcomes for non-surgical otolaryngology interventions is encouraged

Die routinemäßige Gaumenbogennaht nach Tonsillektomie zur Reduktion der Nachblutungsquote

Einleitung: Die Reduktion des Nachblutungsrisikos bleibt eine zentrale Frage bei der Tonsillektomie. Im Rahmen der Uvulopalatopharyngoplastik werden die Gaumenbögen vernäht und Nachblutungen hatten wir hierbei nie beobachtet. Aus diesem Grund wurde Mitte 2006 in unserer Abteilung die routinemäßige Vernähung der Gaumenbögen nach Tonsillektomie wegen chronischer oder rezidivierender Tonsillitis eingeführt. Methode: Es wurden retrospektiv zwei historische Kollektive aus den Jahren 2005 (n= 431) und 2007 (n=338) miteinander verglichen. Eingang in die Auswertung fanden alle Patienten, die wegen einer rezidivierenden oder chronischen Tonsillitis elektiv operiert wurden. In beiden Gruppen wurden intraoperative Blutungen vornehmlich durch Umstechungen gestillt. Ergebnis: Die Quote für operationspflichtige Nachblutungen betrug in 2005 3,7% (KI 0,022 - 0,060) versus 2,1% (KI 0,008 - 0,042) in 2007. Schlussfolgerungen: Es zeigt sich somit ein deutlicher Trend zu Gunsten der Gaumenbogennaht. Im Vergleich zur internationalen Literatur haben wir nun eine sehr geringe Nachblutungsquote