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Looking after a child with an illness places a burden on the family, including sleepless nights, time off work, worry and expense. The impact of a disease on the family is something that should be measurable. The extent to which it influences parents' decisions regarding surgery for their children is not yet known, but there is evidence that parental factors play a large part in the decision to seek medical attention for a child [1]. We already know that parents hold differing beliefs from health care professionals regarding the diagnosis, prognosis and treatment options for common ENT conditions [1], and that operation rates for tonsillectomy and ventilation tubes vary widely from one place to another in the UK without obvious reason [2, 3]. Research to understand the parental viewpoint and its effect on variability in decision-making is essential to move towards a more equitable and efficient service.

To measure the impact of recurrent acute otitis media (RAOM), otitis media with effusion (OME) and recurrent acute sore throat on the rest of the child's family.

A consecutive series of newly referred children with suspected OME, RAOM or sore throats was studied. At the time of their first hospital visit, the parents were asked to complete the MRC Quality of Family Life (QOFL) questionnaire, a 28-question instrument that encompasses a wide range of aspects of family life [4, 5]. Children's quality of life measures (directly rated on a 10-cm visual analogue scale, and indirectly assessed with the Child Health Questionnaire [6]) and clinical data were collected at the same time.

A total of 251 children were studied, aged 1–14 (median 5). The referral diagnosis was OME in 123 children, RAOM in 55, and sore throats in 73. QOFL scores were significantly worse for the RAOM and sore throats groups than for the OME group (Fig. 1). Within these groups, worse QOFL scores were associated with a worse reported quality of life for the child (Fig. 2), and with more severe disease (frequency of sore throats, frequency of otalgia, frequency of pyrexia, time off school; Fig. 3). Within the OME group, however, there was no association between QOFL scores and pure tone average or tympanometry result. Scores were not associated with extraneous factors such as age, sex and social class.

OME, RAOM and sore throats have a measurable impact on the family's quality of life. Recurrent pyrexial illnesses seem to have a greater impact than OME. The MRC QOFL instrument may be useful for future research on factors that influence surgical decision-making.