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Measuring benefit from non-surgical interventions in otolaryngology for different conditions, using the revised
Haytham Kubba1, William M Whitmer1, George G Browning1
1Hearing Sciences - Scottish Section, University of Nottingham, Glasgow Royal Infirmary, Glasgow, UK.
Objectives:
The Glasgow Benefit Inventory (GBI) has been extensively used to report the benefit from otolaryngological surgery. Benefit from non-surgical management has not been reported, despite this being the outcome of most otolaryngology and audiology consultations.
Design:
GBI responses from 4543 adults from the Scottish ENT Outcome Study were categorised by diagnosis. Benefit scores for different interventions within diagnostic categories for which surgery was not a potential management are reported using the revised 5-factor Glasgow Benefit Inventory (GBI-5F; 15 questions and 5 factors).
Setting:
Adult otolaryngology outpatient clinics in six university hospitals.
Participants:
Adults seen with conditions that had no surgical option and given non-surgical management.
Results:
Overall, 80% of participants managed in Scottish Ear Nose and Throat Outcome Study (SENTOS) did not have surgery. A total of 1373 (30%) participants with various diagnoses were given reassurance and advice with no active intervention. There was no change in their GBI-5F total or factor scores, suggesting that they did not come to harm from their lack of active intervention. Hearing aids for bilateral sensorineural hearing loss gave greater benefit than reassurance in all factors, though individuals with a conductive impairment reported greater benefit in the Quality of life factor than those with a sensorineural impairment. Hearing aids and maskers produced benefit in the Support factor for patients with tinnitus. Epley's manoeuvre for benign paroxysmal positional vertigo gave benefit in the total score and the Quality of life factor compared with reassurance. Systemic medication for laryngo-pharyngeal reflux and topical medication for otitis externa gave no greater benefit in any factor or the total score compared with reassurance.
Conclusion:
The GBI-5F and its five factors give useful information for reporting the benefit of non-surgical interventions in adult otolaryngology and audiology clinics.
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