American Speech-Language-Hearing Association

EBP Compendium: Summary of Systematic Review

Agency for Healthcare Research and Quality
Evidence Assessment of the Accuracy of Methods of Diagnosing Middle Ear Effusion in Children with Otitis Media with Effusion

Takata, G. S., Chan, L. S., et al. (2003).
Pediatrics, 112(6 Pt 1), 1379-1387.

Indicators of Review Quality:

The review addresses a clearly focused question Yes
Criteria for inclusion of studies are provided Yes
Search strategy is described in sufficient detail for replication Yes
Included studies are assessed for study quality Yes
Quality assessments are reproducible Yes

Description: This is a review of studies investigating the accuracy of methods used to diagnose middle ear effusion in children with otitis media.

Question(s) Addressed:

What are the sensitivity, specificity, and predictive values for alternative methods of diagnosing OME compared with one of the reference standards?

Population: Children 12 years or younger

Intervention/Assessment: Assessment of otitis media

Number of Studies Included: 52

Years Included: Through January 2000

Findings:

Conclusions:

  • Assessment/Screening
    • Assessment Instruments
      • Hearing
        • Pneumatic Otoscopy & Tympanometry
          • The meta-analyses revealed that pneumatic otoscopy and professional tympanometry had the highest sensitivity compared with myringotomy. Although the diagnostic test with the highest specificity was professional tympanometry (using static compensated acoustic admittance at 0.1), pneumatic otoscopy optimized both sensitivity and specificity. However, the poor quality of many of the studies included in the analysis must be considered. Moreover, most studies failed to provide enough information to assess the qualifications of testers" (p. 1383).
          • "...[O]ur findings suggest that acoustic reflectometry does not perform as well as pneumatic otoscopy and certain types of tympanometry" (p. 1383).
        • Otoscopy & Air/Bone Threshold Audiometry - "Because of inadequate evidence, we could not conduct evaluations of clinical signs and/or symptoms, air and/or bone threshold audiometry, binocular microtympanoscopy, and nonpneumatic otoscopy in the diagnosis of OME" (p. 1385).
        • Acoustic Reflectometry - "...[O]ur findings suggest that acoustic reflectometry does not perform as well as pneumatic otoscopy and certain types of tympanometry" (p. 1383) 

Keywords: Otitis Media

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Added to Compendium: December 2011

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