BACKGROUND: Watchful waiting management of nonsevere acute otitis media (AOM) can reduce the use of antibiotics, but it requires a reliable means of assessing clinical severity. OBJECTIVE: We present the development of a pocket AOM card with which the clinician can rapidly assess total AOM severity. DESIGN/ METHODS: The components of the pocket card consisted of a faces scale, to assess parent perception of severity, and a standard set of tympanic membrane photographs, with which the pediatrician can grade the severity of tympanic membrane inflammation. The components of the pocket card were tested for validity, reliability and responsiveness with the use of data from parents, pediatricians and pediatric otolaryngologists. STATISTICS: Instruments were assessed for concurrent correlation, sequence validity and reliability against previously published questionnaires with the use of Spearman correlation. Responsiveness was calculated with the use of enrollment, day 12 and day 30 data from a randomized clinical trial. RESULTS: The components of the pocket AOM card demonstrated excellent sequence validity, concurrent correlation and reliability (r = 0.58-0.99). Total AOM card severity, consisting of the sum of the 2 scales, demonstrated better responsiveness to change than any of the scales taken individually. CONCLUSIONS: The AOM card combines a parent assessment of symptoms and the clinician assessment of the tympanic membrane to provide an assessment of total AOM severity that can be used to facilitate shared decision making between parent and clinician. The combined score of the AOM card was more responsive to change than any of the instruments used alone. The AOM card provides a useful tool for teaching and research.
RCT Entities:
BACKGROUND: Watchful waiting management of nonsevere acute otitis media (AOM) can reduce the use of antibiotics, but it requires a reliable means of assessing clinical severity. OBJECTIVE: We present the development of a pocket AOM card with which the clinician can rapidly assess total AOM severity. DESIGN/ METHODS: The components of the pocket card consisted of a faces scale, to assess parent perception of severity, and a standard set of tympanic membrane photographs, with which the pediatrician can grade the severity of tympanic membrane inflammation. The components of the pocket card were tested for validity, reliability and responsiveness with the use of data from parents, pediatricians and pediatric otolaryngologists. STATISTICS: Instruments were assessed for concurrent correlation, sequence validity and reliability against previously published questionnaires with the use of Spearman correlation. Responsiveness was calculated with the use of enrollment, day 12 and day 30 data from a randomized clinical trial. RESULTS: The components of the pocket AOM card demonstrated excellent sequence validity, concurrent correlation and reliability (r = 0.58-0.99). Total AOM card severity, consisting of the sum of the 2 scales, demonstrated better responsiveness to change than any of the scales taken individually. CONCLUSIONS: The AOM card combines a parent assessment of symptoms and the clinician assessment of the tympanic membrane to provide an assessment of total AOM severity that can be used to facilitate shared decision making between parent and clinician. The combined score of the AOM card was more responsive to change than any of the instruments used alone. The AOM card provides a useful tool for teaching and research.
Authors: David P McCormick; Kristofer Jennings; Linda C Ede; Pedro Alvarez-Fernandez; Janak Patel; Tasnee Chonmaitree Journal: Int J Pediatr Otorhinolaryngol Date: 2015-12-18 Impact factor: 1.675
Authors: Katsiaryna Holl; Mats Rosenlund; Carlo Giaquinto; Sven-Arne Silfverdal; Alfonso Carmona; James Larcombe; José Garcia-Sicilia; Ahmet Fuat; Maria Eulalia Muñoz; María Luisa Arroba; Brigitte Sloesen; Jens Vollmar; Jean-Yves Pirçon; Johannes G Liese Journal: Clin Drug Investig Date: 2015-10 Impact factor: 2.859
Authors: Miguel W Tregnaghi; Xavier Sáez-Llorens; Pio López; Hector Abate; Enrique Smith; Adriana Pósleman; Arlene Calvo; Digna Wong; Carlos Cortes-Barbosa; Ana Ceballos; Marcelo Tregnaghi; Alexandra Sierra; Mirna Rodriguez; Marisol Troitiño; Carlos Carabajal; Andrea Falaschi; Ana Leandro; Maria Mercedes Castrejón; Alejandro Lepetic; Patricia Lommel; William P Hausdorff; Dorota Borys; Javier Ruiz Guiñazú; Eduardo Ortega-Barría; Juan P Yarzábal; Lode Schuerman Journal: PLoS Med Date: 2014-06-03 Impact factor: 11.069