Heikki Teppo1, Matti Revonta. 1. Department of Otorhinolaryngology, Kanta-Hame Central Hospital, Hameenlinna, Finland. heikki.teppo@khshp.fi
Abstract
OBJECTIVE: This study aimed at evaluating the diagnostic accuracy of a consumer model acoustic reflectometer in the hands of parents in the detection of middle-ear fluid among children. DESIGN: Prospective diagnostic study according to STARD guidelines. Acoustic reflectometry recorded by the parents was compared with otomicroscopic myringotomy with suction in general anaesthesia, performed immediately afterwards. SETTING: Secondary care (Kanta-Hame Central Hospital, Finland). PATIENTS: Pre-school (<7 years) children undergoing otomicroscopic myringotomy due to recurrent acute otitis media or suspicion of glue ear. MAIN OUTCOME MEASURES: Sensitivity, specificity, and positive and negative predictive values of acoustic reflectometry. RESULTS: Consumer model acoustic reflectometry performed by parents reached sensitivity of 94% (95% confidence interval 88-100%) and negative predictive value of 92% (83-100%) with result 1 (green colour) on a scale of 1-5. On the other hand, the method was not very specific and positive predictive value was poor. CONCLUSIONS: The negative screening result was very reliable. Thus, home screening of otitis among otitis-prone children and home follow-up of resolution of middle-ear fluid afterwards deserves to be studied in the home setting in the future.
OBJECTIVE: This study aimed at evaluating the diagnostic accuracy of a consumer model acoustic reflectometer in the hands of parents in the detection of middle-ear fluid among children. DESIGN: Prospective diagnostic study according to STARD guidelines. Acoustic reflectometry recorded by the parents was compared with otomicroscopic myringotomy with suction in general anaesthesia, performed immediately afterwards. SETTING: Secondary care (Kanta-Hame Central Hospital, Finland). PATIENTS: Pre-school (<7 years) children undergoing otomicroscopic myringotomy due to recurrent acute otitis media or suspicion of glue ear. MAIN OUTCOME MEASURES: Sensitivity, specificity, and positive and negative predictive values of acoustic reflectometry. RESULTS: Consumer model acoustic reflectometry performed by parents reached sensitivity of 94% (95% confidence interval 88-100%) and negative predictive value of 92% (83-100%) with result 1 (green colour) on a scale of 1-5. On the other hand, the method was not very specific and positive predictive value was poor. CONCLUSIONS: The negative screening result was very reliable. Thus, home screening of otitis among otitis-prone children and home follow-up of resolution of middle-ear fluid afterwards deserves to be studied in the home setting in the future.
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