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首页> 外文期刊>BMC Pediatrics >Rationale for and design of the 'POSTA' study: Evaluation of neurocognitive outcomes after immediate adenotonsillectomy compared to watchful waiting in preschool children
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Rationale for and design of the 'POSTA' study: Evaluation of neurocognitive outcomes after immediate adenotonsillectomy compared to watchful waiting in preschool children

机译：“ POSTA”研究的基本原理和设计：对学龄前儿童进行即时腺腺扁桃体切除术与观察等待后的神经认知结果进行评估

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Background IQ deficits are linked to even mild obstructive sleep apnoea (OSA) in children. Although OSA is commonly first diagnosed in the pre-school age group, a randomised trial is still needed to assess IQ outcomes after adenotonsillectomy in the pre-school age-group. This randomised control trial (RCT) will primarily determine whether adenotonsillectomy improves IQ compared to no adenotonsillectomy after 12?months, in preschool (3–5 year-old) children with mild to moderate OSA. Methods This protocol is for an ongoing multi-centred RCT with a recruitment target of 210 subjects (105 in each arm). Children age 3–5 years with symptoms of OSA, are recruited through doctor referral, at the point of referral to the Ear Nose and Throat (ENT) services. Screening is initially with a questionnaire (Paediatric Sleep Questionnaire, PSQ) for symptoms of obstructive sleep apnoea (OSA). Where questionnaires are positive (suggestive of OSA) and ENT surgeons recommend them for adenotonsillectomy, they are invited to participate in POSTA. Baseline testing includes neurocognitive testing (IQ and psychometric evaluation with the neuropsychologist blinded to randomisation) and overnight polysomnography (PSG). Where the Obstructive Apnoea-Hypopnea Index (OAHI) from the PSG is Discussion If IQ deficits associated with OSA are reversible 12?months after adenotonsillectomy compared to controls, future clinical practice advise would be to undertake early surgery in young children with OSA. The study could provide data on whether a window of opportunity exists for reversing IQ deficits linked to OSA in the pre-school age-group. Trial registration Australian and New Zealand Clinical Trials Registration Number ACTRN12611000021976 .
机译：背景智商不足甚至与儿童轻度阻塞性睡眠呼吸暂停（OSA）有关。尽管通常在学龄前儿童中首先诊断出OSA，但仍需要进行一项随机试验来评估学龄前儿童进行腺扁桃体切除术后的智商结果。这项随机对照试验（RCT）将主要确定在轻度至中度OSA的学龄前儿童（3-5岁）中，腺扁桃体切除术与12个月后无腺扁桃体切除术相比是否能改善智商。方法该方案适用于正在进行的多中心RCT，招募目标为210名受试者（每组105名）。患有OSA症状的3至5岁儿童在转诊至耳鼻喉科（ENT）时通过医生转诊招募。最初使用问卷调查（小儿睡眠问卷，PSQ）进行阻塞性睡眠呼吸暂停（OSA）症状的筛查。如果问卷调查表呈阳性（建议OSA）且耳鼻喉科医生推荐他们进行腺扁桃体切除术，则邀请他们参加POSTA。基线测试包括神经认知测试（IQ和神经心理学家对随机化视而不见的心理测评）和通宵多导睡眠图（PSG）。如果讨论PSG的阻塞性呼吸暂停低通气指数（OAHI），如果与对照相比，在腺扁桃体切除术后12个月与OSA相关的智商缺陷可逆，则未来的临床实践建议是对OSA幼儿进行早期手术。该研究可以提供有关在学龄前儿童中是否存在逆转与OSA相关的智商不足的机会之窗的数据。试验注册澳大利亚和新西兰临床试验注册编号ACTRN12611000021976。

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