Severity of inflammation of tympanic membrane as predictor of clinical course of recurrent acute otitis media.

Appelman, C. L. M.; Claessen, J. Q. P. J.; Touw-Otten, F. W. M. M.; Hordijk, G. J.; Melker, R A de

doi:10.1136/bmj.306.6882.895

Cited by 17 publications

(3 citation statements)

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“…Assigning predictive value to colour of nasal discharge or sputum when suspecting sinusitis has been described [16]. Examination of the eardrum is a key component in GPs' diagnosis of acute otitis media [17], although its appearance might not predict the clinical course [18]. Physicians' concerns regarding rapid streptococcus tests are known from the literature [19].…”

Section: Discussionmentioning

confidence: 99%

Diagnosing infections: a qualitative view on prescription decisions in general practice over time

2010

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Large variability and individuality characterized the GPs' diagnostic procedures, contrasted by consistency through time. If modification of diagnostic routines is needed, provision of "scientific facts" and technological aids is insufficient. A prerequisite for changing practice is GPs' acceptance of accuracy of information and of reliability, applicability, and relevance of technology, for physician and/or patient.

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Section: Discussionmentioning

confidence: 99%

Diagnosing infections: a qualitative view on prescription decisions in general practice over time

2010

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“…Fourth, we defined a GP-diagnosis of AOM as an ICPC code H71 recorded in the GP health records. Variation in AOM coding between GPs and misclassification of AOM cannot be ruled out, in particular in this young age group where otoscopic confirmation is known to be difficult [ 23 ]. Furthermore, a GP-diagnostic code was not available for 39 of the 326 (12%) GP-consultations.…”

Section: Discussionmentioning

confidence: 99%

Parent-Reported Symptoms of Acute Otitis Media during the First Year of Life: What Is beneath the Surface?

et al. 2015

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BackgroundMost estimates of the incidence of acute otitis media (AOM) are based on general practitioner (GP) or pediatrician diagnoses. It is likely that these figures underestimate the community incidence of AOM since parents do not visit their doctor every time their child suffers from acute ear symptoms. The impact of these symptom episodes may be substantial since they affect the child’s quality of life and parents’ productivity.MethodsTo determine AOM symptoms in the community, we measured parent-reported AOM symptoms daily for 12 consecutive months in 1,260 children participating in a prospective birth cohort in the Netherlands. The mean age of these children was at study enrollment 0.9 months (standard deviation 0.6). A parent-reported AOM symptom episode was defined as fever (temperature 38˚C or above) plus at least one of the following symptoms: ear pain and ear discharge. These febrile AOM symptom episodes were linked to GP-consultations and diagnoses in the GP electronic health records.ResultsWith an estimated 624 parent-reported symptom episodes per 1,000 child-years (95% CI: 577 to 674) incidence of febrile AOM symptoms during the child’s first year is high. The GP was consulted in half of these symptom episodes and AOM was diagnosed in 49% of these consultations.Conclusions and RelevanceThe incidence of febrile AOM symptoms in the first year of life is high in Dutch children and leads to a GP-consultation in only half of the cases. This suggests that AOM symptomatology in the community is underestimated when focusing on GP-diagnosed AOM episodes alone, since a considerable proportion of febrile AOM symptom episodes are treated symptomatically by parents at home and do not come to the attention of the GP. Having data on community AOM symptomatology available for each country is important when the potential impact of preventive and therapeutic interventions for AOM are studied.

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“…Appelman et al found that signs of tympanic inflammation did not predict the course of acute otitis media. 1 Pneumatic otoscopy was proposed as an alternative criteria, but a review by Preston showed that pneumatic otoscopy predicted only serous otitis and not acute otitis media. 2 Therefore, accurate diagnosis is still an issue and confounds conclusions about outcomes.…”

Section: Commentarymentioning

confidence: 99%

Review: antibiotics are moderately effective for acute otitis media in children

Wright

2004

Evid Based Nurs

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Severity of inflammation of tympanic membrane as predictor of clinical course of recurrent acute otitis media.

Cited by 17 publications

References 1 publication

Diagnosing infections: a qualitative view on prescription decisions in general practice over time

Diagnosing infections: a qualitative view on prescription decisions in general practice over time

Parent-Reported Symptoms of Acute Otitis Media during the First Year of Life: What Is beneath the Surface?

Review: antibiotics are moderately effective for acute otitis media in children

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