Table 1. Baseline Characteristics of Trial Participantsa.
| No. (%) | ||
|---|---|---|
| Early adenotonsillectomy (n = 231) | Watchful waiting (n = 227) | |
| Age, median (IQR), y | 6 (4-8) | 6 (4-8) |
| Sex, No. (%) | ||
| Female | 119 (51.5) | 111 (48.9) |
| Male | 112 (48.5) | 116 (51.1) |
| Race, No./total (%)b | ||
| American Indian/Alaska Native | 2/230 (0.9) | 1/227 (0.4) |
| Asian | 3/230 (1.3) | 5/227 (2.2) |
| Black/African American | 60/230 (26.1) | 63/227 (27.6) |
| Multiracial | 10/230 (4.3) | 10/227 (4.4) |
| White | 155/230 (67.4) | 148/227 (65.2) |
| Ethnicity, No. (%)b | ||
| Hispanic/Latinx | 42 (18.2) | 33 (14.5) |
| Non-Hispanic/Latinx | 189 (81.8) | 194 (85.5) |
| Maternal education, No./total (%) | ||
| High school diploma or less | 46/229 (20.1) | 40/227 (17.6) |
| Some college | 91/229 (39.7) | 93/227 (41.0) |
| 4-Year college or greater | 92/229 (40.2) | 94/227 (41.4) |
| Annual household income <$30 000 | 71/213 (33.3) | 56/210 (26.7) |
| Childhood Opportunity Index, median (IQR)c | 51 (22-75) [n = 229] | 58 (29-78) [n = 226] |
| Study site location, No. (%) | ||
| Ann Arbor, Michigan | 42 (18.2) | 42 (18.5) |
| Cincinnati, Ohio | 43 (18.6) | 41 (18.1) |
| Cleveland, Ohio | 33 (14.3) | 33 (14.5) |
| Dallas, Texas | 46 (19.9) | 45 (19.8) |
| Norfolk, Virginia | 33 (14.3) | 33 (14.5) |
| Philadelphia, Pennsylvania | 34 (14.7) | 33 (14.5) |
| Diagnosed asthma, No./total (%) | 53/230 (23.0) | 55/227 (24.2) |
| Current ADHD medication, No./total (%) | 11/230 (4.8) | 7/227 (3.1) |
| BMI (z score), median (IQR)d | 0.7 (−0.3 to 1.4) | 0.6 (−0.3 to 1.5) |
| BMI weight classification, No. (%)e | ||
| Healthy weight | 138 (59.7) | 132 (58.1) |
| Underweight | 7 (3.0) | 12 (5.3) |
| Overweight | 47 (20.3) | 34 (15.0) |
| Obese | 39 (16.9) | 49 (21.6) |
| Tonsil grade, No. (%)f | ||
| II | 84 (36.4) | 92 (40.5) |
| III | 127 (55.0) | 119 (52.4) |
| IV | 20 (8.7) | 16 (7.0) |
| Measures, No./total (%) | ||
| BRIEF GEC T score ≥65g | 52/230 (22.6) | 57/227 (25.1) |
| CBCL total problems T score ≥60h | 65/227 (28.6) | 62/224 (27.7) |
| PSQ-SRBD score ≥0.33i | 176/229 (76.9) | 167/227 (73.6) |
| mESS total score ≥10j | 50/227 (22.0) | 57/227 (25.1) |
| OSA-18 ≥60k | 66/229 (28.8) | 68/227 (30.0) |
| Frequent loud snoring, No./total (%)l | 125/229 (54.6) | 125/227 (55.1) |
| AHI (events/h), median (IQR)m | 0.5 (0.1-1.1) | 0.6 (0.3-1.2) |
Abbreviations: ADHD, attention-deficit/hyperactivity disorder; BMI, body mass index; BRIEF, Behavior Rating Inventory of Executive Function; CBCL, Child Behavior Checklist; GEC, global executive composite; mESS, modified Epworth Sleepiness Scale; OSA, obstructive sleep apnea; PSQ-SRBD, Sleep-Related Breathing Disorder scale of the Pediatric Sleep Questionnaire.
Primary analysis included all participants in the Pediatric Adenotonsillectomy Trial for Snoring other than 1 child who was randomized from Boston Children’s Hospital (site started and closed recruitment early); this participant was excluded from this table.
Race and ethnicity were based on caregiver responses to categories provided in a questionnaire and were collected as proxies for structural and social disadvantage.
A census tract–level composite measure comprised of an education index, health and environment index, and social and economic index. Scores range from 1 to 100; higher scores indicate greater overall levels of opportunity.
BMI calculated as weight in kilograms divided by the square of height in meters. BMI z scores are age- and sex-standardized transformations of BMI that range from positive to negative infinity, with z scores 3 or greater indicating obesity.
Categories based on BMI percentile, which compares the child’s weight to that of other children of the same age and sex. Underweight: BMI in less than the fifth percentile; healthy weight: BMI in the 5th to 85th percentile; overweight: BMI in the 85th to 95th percentile; obese: BMI in the 95th percentile or greater.
Maximum Brodsky tonsil grade across both the left and right tonsils, determined by physical examination as the percentage of the oropharyngeal airway that the tonsil occupies: size I, 0% to 25%; size II, 26% to 50%; size III, 51% to 75%; size IV, more than 75%.
The BRIEF GEC comprises summary measures of behavioral regulation, emotion regulation, and cognitive regulation (BRIEF-2, for children ages 5 to 18 years) or inhibitory self-control, flexibility, and emergent metacognition (BRIEF-P, for preschool-aged children). Caregiver scores ranged from 33 to 102, with higher scores indicating worse functioning. A T score of 65 or greater is considered potentially clinically elevated.
The CBCL total problems summary scale comprises internalizing, externalizing, social, thought, and attention problems. Scores ranged from 24 to 84, with higher scores indicating greater emotional, social, and behavioral problems. A T score of 60 or greater indicates that the child is at risk for clinical problem behaviors.
Scores range from 0 to 1, with higher scores indicating greater severity. A score of 0.33 or greater suggests a high risk for a pediatric sleep-related breathing disorder.
Scores on the mESS range from 0 to 24, with higher scores indicating greater sleepiness. A score of 10 or greater represents excessive daytime sleepiness.
Scores on the OSA-18 quality of life survey range from 18 to 126, with higher scores indicating a greater negative effect of sleep-disordered breathing on quality of life. A score of 60 or greater represents a moderate to severe negative effect.
Snoring was assessed using item 1a of the OSA-18 quality of life survey, which uses a Likert scale to ask about the frequency of loud snoring over the last 4 weeks. Possible responses ranged from “none of the time” to “all of the time”; loud snoring was considered frequent if it occurred “a good bit of the time,” “most of the time,” or “all of the time.”
AHI defined as the average number of apneas or hypopneas (hypopneas defined ≥3% oxygen desaturation or arousal) per hour of sleep by polysomnography, with higher scores indicating more severe obstructive sleep apnea. In pediatric populations, AHI levels greater than 1 to 5 are considered indicative of obstructive sleep apnea. AHI levels were rounded to the nearest tenth.