Part 1. GOSH / RHSC ear reconstruction study: how did it work, and who took part?

The researchers contacted two sets of children. The first were those who had completed ear reconstruction at Great Ormond Street Hospital, with Neil Bulstrode, between 2011 and 2013. The second were those who completed reconstruction with Ken Stewart at the Royal Hospital for Sick Children, between 2003 and 2013.

115 GOSH patients, who had their operations between eight months and three years before this study, were sent questionnaires. GOSH patients were sent two different surveys, and only the results from the second are discussed in this blog.

This is because the second is better designed than the first, and because the second questionnaire was also sent to RHSC children, which allows comparisons. 42 of the 115 GOSH patients contacted returned the second questionnaire (37%). The average age of these children at completion of surgery was 11.

A higher proportion of RHSC children completed their surveys: 56%. However, a smaller number of patients were contacted – 48, with 27 returning the questionnaire. The average age of these children at completion of surgery was 14.

So all the findings that will be discussed in this blog are for 27 individual RHSC patients, who had surgery across an 11 year period. For GOSH patients, they are for 42 individuals who had surgery over a three year period.

The fact that only 37% of GOSH patients and 56% of RHSC patients contacted took part in this study means that we have to be very careful in understanding its results. The children who did not reply may have given very different answers to those who did.

We can’t assume that this research applies to all individuals who have had surgery with Neil Bulstrode or Ken Stewart. As discussed in the original article, it is possible, for example, that some children may not take part because of concerns about how their replies may affect their ongoing care.

It is also possible that those who have had more negative experiences are more likely to reply – or, alternatively, those who are happier with the results of their surgery are happier to respond.

Despite these limitations, what this study can very usefully tell us is how those people who took part in it feel about their ears after surgery.

This may help with considering the pros and cons of reconstructive options (including doing nothing), and raise questions to ask surgeons. The surveys also included questions on factors such as post-operative care and pain relief – and answers on these points may also help planning and decisions.

The full journal article can be found here: http://www.jprasurg.com/article/S1748-6815(16)30484-3/abstract

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