A UK government leaflet alerting doctors to the ineffectiveness of grommets for persistent glue ear (chronic otitis media with effusion) is credited with the consistent decrease in their use over the last 15 years.
The rate of grommet insertion began to fall after the 1992 publication of an Effective Health Care Bulletin on treating persistent glue ear in children. To test whether it was the leaflet or a natural downward trend, researchers from the University of Newcastle upon Tyne also looked at rates for tonsillectomy - another elective procedure in the same speciality.
They found that tonsillectomy rates had increased steadily over the same period, suggesting that providing doctors with clear guidelines on how best to treat glue ear did have a significant effect in practice.
The researchers estimate that in the four years after distribution of the leaflet, nearly 90,000 unnecessary grommet insertions were avoided (BMJ, 2001; 323: 1096-7).