The review is clearly-written and the search strategy and some details of the studies included in the review are given. However, some key facts are missing, i.e. details of the control procedure and numbers in each group are not adequately reported.
Some limitations of the review are acknowledged by the author, namely, the use of only one reviewer, the restricted search strategy (no handsearching), and the paucity of details given in the five RCTS which were retrieved.
The author's conclusion that the effectiveness of tonsillectomy needs to be considered in the light of its adverse effects does not follow from the results presented. Adverse effects due to the procedure were not reported in the RCTs retrieved and the suggestion is that they be included as an outcome measure in future RCTs.
The review is a useful preliminary document which draws attention to the relatively poor quality of existing RCTs in this area of research.