Comparison of Spectral Gradient Acoustic Reflectometry and Tympanometry for Detection of Middle-ear Effusion in Children

Puhakka, Tuomo; Pulkkinen, Jaakko; Silvennoinen, Heli; Heikkinen, Terho

doi:10.1097/inf.0000000000000273

Cited by 19 publications

(9 citation statements)

References 18 publications

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“…Pneumatic otoscopy, tympanometry and spectral-gradient acoustic reflectometry were used in diagnosing acute otitis media (AOM). 25 Children without any complications at the first visit were routinely reexamined after 5-7 days and additionally whenever the parents deemed it necessary. Any complications were considered to be associated with influenza if they were diagnosed within 14 days after the visit at which the influenza-positive specimen was obtained; no other virus had been detected; the child had not been asymptomatic in the meantime.…”

Section: Subjects and Study Conductmentioning

confidence: 99%

Comparative Burden of Influenza A/H1N1, A/H3N2 and B Infections in Children Treated as Outpatients

Silvennoinen

Huusko

Vuorinen

et al. 2015

Pediatric Infectious Disease Journal

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Section: Subjects and Study Conductmentioning

confidence: 99%

Comparative Burden of Influenza A/H1N1, A/H3N2 and B Infections in Children Treated as Outpatients

Silvennoinen

Huusko

Vuorinen

et al. 2015

Pediatric Infectious Disease Journal

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“…Chest or sinus radiographs were routinely obtained for all children who were clinically suspected of having pneumonia or sinusitis. Pneumatic otoscopy, tympanometry and spectral-gradient acoustic reflectometry were used for diagnosing acute otitis media [17]. Children without any complications at the first visit were routinely reexamined after 5-7 days and whenever the parents deemed it necessary.…”

Section: Study Conductmentioning

confidence: 99%

Clinical and socioeconomic impact of moderate-to-severe versus mild influenza in children

Heikkinen

Silvennoinen

Heinonen

et al. 2016

Eur J Clin Microbiol Infect Dis

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Some studies have assessed the efficacy of influenza vaccination in children separately for moderate-to-severe and any influenza, but the definition used for identifying children with moderate-to-severe illness has not been validated. We analyzed clinical and socioeconomic data from two prospective cohort studies of respiratory infections among children aged ≤13 years (four influenza seasons, 3,416 child-seasons of follow-up). We categorized children with laboratory-confirmed influenza into two mutually exclusive groups of moderate-to-severe and mild influenza using the previously proposed criteria. We obtained the data for the analyses from structured medical records filled out by the study physicians and from daily symptom cards filled out by the parents. Of 434 cases of influenza, 217 (50 %) were classified as moderate-to-severe and 217 (50 %) as mild. The mean duration of fever was 4.0 days in children with moderate-to-severe influenza and 3.1 days in those with milder illness (P < 0.0001). Antibiotics were prescribed to 111 (51 %) children with moderate-to-severe and to ten (5 %) children with mild influenza (P < 0.0001). The rates of parental work absenteeism were 184 days per 100 children with moderate-to-severe influenza and 135 days per 100 children with mild influenza (P = 0.02). The corresponding rates of children's own absenteeism from day care or school were 297 and 233 days respectively per 100 children (P = 0.006). Categorization of children into groups with moderate-to-severe and mild influenza is meaningful, and it identifies children in whom the clinical and socioeconomic impact of influenza is highest. Illness severity should be considered when assessing influenza vaccine effectiveness in children.

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“…Furthermore, in our study, SG-AR was not reliable in the exclusion of MEE. In study settings with a low prevalence of MEE and/or an older age group of children, higher negative predictive values for SG-AR have been reported [ 15 , 17 ]. However, because level 1 is a rare result, excluding MEE with SG-AR cannot be considered useful in routine ear controls.…”

Section: Discussionmentioning

confidence: 99%

Can nurses exclude middle-ear effusion without otoscopy in young asymptomatic children in primary care?

Laine

Tähtinen

Ruuskanen

et al. 2015

Scandinavian Journal of Primary Health Care

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Objective. Scandinavian guidelines recommend controlling middle-ear effusion (MEE) after acute otitis media. The study aim was to determine whether nurses without otoscopic experience can reliably exclude MEE with tympanometry or spectral gradient acoustic reflectometry (SG-AR) at asymptomatic visits. Design. Three nurses were taught to perform examinations with tympanometry and SG-AR. Pneumatic otoscopy by the study physician served as the diagnostic standard. Setting. Study clinic at primary health care level. Patients. A total of 156 children aged 6–35 months. Main outcome measures. Predictive values (with 95% confidence interval) for tympanometry and SG-AR, and the clinical usefulness, i.e. the proportion of visits where nurses obtained the exclusive test result from both ears of the child. Results. At 196 visits, the negative predictive value of type A and C1 tympanograms (tympanometric peak pressure > −200 daPa) was 95% (91–97%). Based on type A and C1 tympanograms, the nurse could exclude MEE at 81/196 (41%) of visits. The negative predictive value of SG-AR level 1 result was 86% (79–91%). Based on SG-AR level 1 results, the nurse could exclude MEE at 29/196 (15%) of visits. Conclusion. Tympanograms with tympanometric peak pressure > −200 daPa (types A and C1) obtained by nurses are reliable test results in excluding MEE. However, these test results were obtained at less than half of the asymptomatic visits and, thus, the usefulness of excluding MEE by nurses depends on the clinical setting.

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Comparison of Spectral Gradient Acoustic Reflectometry and Tympanometry for Detection of Middle-ear Effusion in Children

Cited by 19 publications

References 18 publications

Comparative Burden of Influenza A/H1N1, A/H3N2 and B Infections in Children Treated as Outpatients

Comparative Burden of Influenza A/H1N1, A/H3N2 and B Infections in Children Treated as Outpatients

Clinical and socioeconomic impact of moderate-to-severe versus mild influenza in children

Can nurses exclude middle-ear effusion without otoscopy in young asymptomatic children in primary care?

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