Prevalence of Tympanogram Asymmetries and Fluctuations in Otitis media with Effusion: Implications for Binaural Hearing

Stephenson, Helen; Haggard, Mark; Zielhuis, Gerhard A.; P, van den Broek; Schilder, Anne

doi:10.3109/00206099309072932

Cited by 10 publications

(6 citation statements)

References 16 publications

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“…Proportionate clinical response to the severity and persistence/recurrence of OM is required. In epidemiological research this nuancing only arrived in 1997 for AOM [4] and 1993 for OME [91]. To cater simply for single-episode diagnosis and treatment, AOM guidelines have not adequately addressed the gradation issue [48] and the necessary evidence base for it has not been seriously sought.…”

Section: Diagnosis Of Om Versus Severity and Persistence Of Diseasementioning

confidence: 99%

Poor adherence to antibiotic prescribing guidelines in acute otitis media—obstacles, implications, and possible solutions

Haggard

2010

Eur J Pediatr

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Many countries now have guidelines on the clinical management of acute otitis media. In almost all, the public health goal of containing acquired resistance in bacteria through reduced antibiotic prescribing is the main aim and basis for recommendations. Despite some partial short-term successes, clinical activity databases and opinion surveys suggest that such restrictive guidelines are not followed closely, so this aim is not achieved. Radical new solutions are needed to tackle irrationalities in healthcare systems which set the short-term physician–patient relationship against long-term public health. Resolving this opposition will require comprehensive policy appraisal and co-ordinated actions at many levels, not just dissemination of evidence and promotion of guidelines. The inappropriate clinical rationales that underpin non-compliance with guidelines can be questioned by evidence, but also need specific developments promoting alternative solutions, within a framework of whole-system thinking. Promising developments would be (a) physician training modules on age-appropriate analgesia and on detection plus referral of rare complications like mastoiditis, and (b) vaccination against the most common and serious bacterial pathogens.

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Section: Diagnosis Of Om Versus Severity and Persistence Of Diseasementioning

confidence: 99%

Poor adherence to antibiotic prescribing guidelines in acute otitis media—obstacles, implications, and possible solutions

Haggard

2010

Eur J Pediatr

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“…The present analysis stipulates that in medically treated children, 50% of cases of AOME have MEE for 1 month, 20% for 2 months, 10% for 3 months, 5% for 4 months, and 2.5% for an additional 4 years (absent any surgical treatment). The Nijmegen experience was similar in that 8% of children had COME for half the 2 years they were studied 8 . This presumption gives a group mean duration of 2 months of effusion from a single bout of AOME.…”

Section: Morbidity Of Omementioning

confidence: 92%

Cost‐Effectiveness Considerations in Otitis Media Treatment

Gates

1996

Otolaryngol.--head neck surg.

130

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The costs of treatment of children with otitis media with effusion comprise a substantial part of the total health care expenditure. However, there is little information about the value of therapy expressed in cost-effectiveness terms, and disagreement still exists about optimal therapy. This article considers the elements of cost-effectiveness analysis as they pertain to treatment of young children with otitis media with effusion and develops a first approximation model using data from several sources. The assumptions on which this model is based need to be validated by additional research. Otitis media with effusion treatment costs are high because of the large, and apparently increasing, number of symptomatic cases. Medical therapy, which is the primary treatment modality, consumes two thirds of the expenditures for otitis media with effusion. Surgical therapy is a cost-effective treatment for children in whom medical therapy for otitis media with effusion fails. Medical and surgical therapy are complementary, and each should be included in the analysis of cost-effectiveness.

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“…At later follow‐up, these same children (spanning ages 3, 5, 7, 9, and 11) showed persistent deficits in verbal comprehension and expression, speech articulation and reading, but not intelligence (Silva, Chalmers, & Stewart, 1986). Teele et al (1990) also provided data from a prospective cohort study supporting the effects of OME on educational development. On 194 children with OME history in the first 3 years of life, they found reading, mathematics, and IQ scores to be significantly associated with time spent with middle ear effusion in the first 3 years of life, after controlling for socio‐economic group.…”

Section: Appendixmentioning

confidence: 99%

Parent versus professional views of the developmental impact of a multi‐faceted condition at school age: Otitis media with effusion (glue ear)

Higson¹,

Haggard²

2005

Brit J of Edu Psychol

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(1) A four-factor reduction of simple questionnaire items well defines the domains of impact of OME, and can express the ways in which views of impact differ between teachers, ENT specialists and parents.(2) Considerable differences of perspective exist between the groups examined. (3) In valuing a set of measured outcomes on actual children, or for other policy research, sets of weights are now available to represent the differing perspectives of parents and professionals (e.g. in testing robustness of a conclusion across differing stakeholder perspectives). (4) The research and development need in respect of teachers' involvement with OME could profitably play to existing strengths. This implies the systematic and structured acquisition and evaluation of teacher-provided impact information.

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Prevalence of Tympanogram Asymmetries and Fluctuations in Otitis media with Effusion: Implications for Binaural Hearing

Cited by 10 publications

References 16 publications

Poor adherence to antibiotic prescribing guidelines in acute otitis media—obstacles, implications, and possible solutions

Poor adherence to antibiotic prescribing guidelines in acute otitis media—obstacles, implications, and possible solutions

Cost‐Effectiveness Considerations in Otitis Media Treatment

Parent versus professional views of the developmental impact of a multi‐faceted condition at school age: Otitis media with effusion (glue ear)

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