Evidence Assessment of the Accuracy of Methods of Diagnosing Middle Ear Effusion in Children With Otitis Media With Effusion

Pediatrics

Takata, G. S., Chan, L. S., et al. (2003).

Pediatrics, 112(6 Pt 1), 1379-1387.

This systematic review investigates the accuracy of methods used to diagnose middle ear effusion in children, 12 years or younger, with otitis media. Of interest to audiologists are conclusions regarding "professional tympanometry, i.e., tympanometry done by an audiologist or individual with specialized knowledge of tympanometry" (p. 1380).

Agency for Healthcare Research and Quality

Through January 2000

English-language studies (excluding case reports, editorials, letters, reviews, practice guidelines)

52 total; 47 articles investigating professional tympanometry

Findings demonstrated that pneumatic otoscopy and professional tympanometry had high sensitivity compared with myringotomy. Professional tympanometry measurements demonstrated the following specificity and sensitivity for diagnosing middle ear effusion in children with otitis media: <ul> <li>Using static compensated acoustic admittance at 0.1 had the highest specificity (94.1% with CI (83.9-100); <em>P</em> value 0.001) with lower sensitivity (33.9% with CI (12.7-55.0); <em>P </em>value &lt;0.001);</li> <li>Using static compensated acoustic admittance at 0.2 had specificity of 87.7% (CI 76.8-98.5; <em>P</em> value &lt;0.001) and sensitivity of 52.2% (CI 39.5-64.8; <em>P</em> value 0.005);</li> <li>Using static compensated acoustic admittance at 0.3&nbsp;had specificity of 48.6% (CI 10.2-87.0; <em>P</em> value &lt;0.001) and sensitivity of 65.4% (CI 39.1-91.7;&nbsp;<em>P</em>&nbsp;value &lt;0.001);</li> <li>Using flat or B curve as abnormal had specificity of 74.5% (CI 66.9-82.0;&nbsp;<em>P</em>&nbsp;value &lt;0.001)&nbsp;and sensitivity of 80.9% (CI 76.1-85.7;&nbsp;<em>P</em>&nbsp;value &lt;0.001); and</li> <li>Using flat or B or C2 curve as abnormal had specificity of 61.8% (CI 41.5-82.1;&nbsp;<em>P</em>&nbsp;value &lt;0.001) and sensitivity of 93.8% (CI 91.1-96.4;&nbsp;<em>P</em>&nbsp;value 0.093).</li> </ul> Limitations to this review include the inclusion of low quality studies and a lack of reporting regarding the qualifications and training of examiners.