Detection of middle-ear fluid in children with spectral gradient acoustic reflectometry: A screening tool for nurses?

Teppo, Heikki; Revonta, Matti; Lindén, Henriikka; Palmu, Arto A.

doi:10.1080/02813430600699997

Cited by 11 publications

(11 citation statements)

References 17 publications

(15 reference statements)

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“…Sensitivity, specificity, and positive and negative predictive values obtained in this study with second-generation professional and consumer model SG-AR devices were similar and comparable to those reported in the literature [2,[11][12][13][14][15][16]. Newer secondgeneration spectral gradient acoustic reflectometers performed clearly better than old first-generation model.…”

Section: Discussionsupporting

confidence: 92%

“…AR usually performs best at the ends of the SG-AR degree spectrum, both confirming MEF in grossly fluid-filled ears and ruling out MEF in healthy ears reliably [2,14,15]: positive predictive values (PPV) of 83-88%, negative predictive values (NPV) of 82-83%, specificities of 79-94% and sensitivities 86-94% have been reported. In our recent study [16], SG-AR reached PPV and NPV of 94 and 98%, and specificity and sensitivity of 98 and 87%, respectively, in the hands of nurses in detecting MEF among children. This indicates good performance even without intimate familiarity with the device.…”

Section: Introductionmentioning

confidence: 94%

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Comparison of old, professional and consumer model acoustic reflectometers in the detection of middle-ear fluid in children with recurrent acute otitis media or glue ear

Teppo

Revonta

2007

International Journal of Pediatric Otorhinolaryngology

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Section: Discussionsupporting

confidence: 92%

Section: Introductionmentioning

confidence: 94%

Comparison of old, professional and consumer model acoustic reflectometers in the detection of middle-ear fluid in children with recurrent acute otitis media or glue ear

Teppo

Revonta

2007

International Journal of Pediatric Otorhinolaryngology

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“…Concerning symptomatic visits, none of the previous studies have investigated the clinical usefulness of tympanometry and SG-AR in primary health care, i.e. the proportion of visits where reliable test results are obtained from both ears of the child [ 4 , 7–11 , 15–17 ]. If tympanometric and/or SG-AR examinations performed by nurses were reliable in excluding AOM, a proportion of the symptomatic children might potentially go home without visiting a physician in the case where the child’s overall condition is normal.…”

Section: Introductionmentioning

confidence: 99%

Can trained nurses exclude acute otitis media with tympanometry or acoustic reflectometry in symptomatic children?

Laine

Tähtinen

Ruuskanen

et al. 2015

Scandinavian Journal of Primary Health Care

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Objective Since acute otitis media (AOM) is the most prevalent bacterial infection in young children, the reliable exclusion of AOM by nurses might save physicians’ time for other duties. The study aim was to determine whether nurses without otoscopic experience can reliably use tympanometry or spectral gradient acoustic reflectometry (SG-AR) to exclude AOM.Design Three nurses were trained, who performed 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. 281 children 6–35 months of age.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 459 visits, the negative predictive value of type A and C1 tympanograms (tympanometric peak pressure >–200 daPa) was 94% (91–97%). Based on type A and C1 tympanograms, the nurse could exclude AOM at 94/459 (20%) of visits. The negative predictive value of SG-AR level 1 result (>95°) was 94% (89–97%). Based on the SG-AR level 1 result, the nurse could exclude AOM at 36/459 (8%) of visits.Conclusion Type A and C1 tympanograms and SG-AR level 1 results obtained by nurses are reliable test results in excluding AOM. However, the clinical usefulness of these test results is limited by their rarity. Type A and C1 tympanograms were obtained by nurses from both ears of the child only at one-fifth of the symptomatic visits.Key PointsAcute otitis media (AOM) is the most prevalent bacterial infection in young children. Nurses’ role in excluding AOM is unknown.Type A and C1 tympanograms (tympanometric peak pressure >–200 daPa) obtained by nurses are reliable test results in excluding AOM.With type A and C1 tympanograms, nurses could exclude AOM only at one-fifth of the symptomatic visits.The clinical usefulness of the exclusion of AOM performed by nurses seems to be limited.

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“…10,11 Despite the potential advantages of spectral gradient acoustic reflectometry (SGAR) over tympanometry, 10,12 few studies have assessed the diagnostic accuracy of SGAR in the outpatient setting where the method would be of the greatest value. [13][14][15][16] In a prospective study of respiratory infections in children, we directly compared the performance of SGAR and tympanometry in unselected children seen in primary care.…”

mentioning

confidence: 99%

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

Puhakka¹,

Pulkkinen²,

Silvennoinen

et al. 2014

Pediatric Infectious Disease Journal

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Detection of middle-ear fluid in children with spectral gradient acoustic reflectometry: A screening tool for nurses?

Cited by 11 publications

References 17 publications

Comparison of old, professional and consumer model acoustic reflectometers in the detection of middle-ear fluid in children with recurrent acute otitis media or glue ear

Comparison of old, professional and consumer model acoustic reflectometers in the detection of middle-ear fluid in children with recurrent acute otitis media or glue ear

Can trained nurses exclude acute otitis media with tympanometry or acoustic reflectometry in symptomatic children?

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

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