Otitis_Media

Canadian Task Force on Preventive Health Care

Recommendation Table

Please note: In 2003, the CTF updated its Grades of Recommendations to include an "I Recommendation" for situations where insufficient evidence exists to allow a recommendation to be made. (Formerly, these situations were captured under a "C Recommendation".) This change is not retroactive, and all "C Recommendations" made prior to 2003 have not been reevaluated in light of the new "I" recommendation grade. For a discussion of these recommendation grades, please link to the 2003 article in the Canadian Medical Association Journal here.

Preventive Health Care, 2000 Update: Screening for Otitis Media with Effusion

Prepared by Christopher C. Butler, BA, MBChB, DCH, MRCGP, CCH, MD, and Harriet MacMillan, MD, MSc, FRCP(C) with the Canadian Task Force on Preventive Health Care

These recommendations were finalized by the Task Force in September 2000.

MANEUVER EFFECTIVENESS LEVEL OF EVIDENCE <REF> RECOMMENDATION

Screening to identify children with clinically important OME (tympanometry, microtympanometry, acoustic reflectometry and pneumo-otoscopy) Performance of various manoeuvres has not been adequately assessed in community settings. No single reading can give an indication of chronicity which is crucial in a condition which is fluctuating and often self-limiting. Cohort (II-2) <Multiple studies> There is insufficient evidence to include routine early screening for otitis media with effusion (OME) in, or exclue it from, the periodic health examination of children up to 4 years of age (C)

Screening to prevent delay in language development as a result of OME No effect on language was identified in a trial that screened children, then randomly assigned those with persistent effusion to be treated with ventilation tubes (versus usual care, delayed surgery or watchful waiting). Randomized controlled trial (I), Cohort (II-2) <69-71> There is insufficient evidence to recommend early screening for OME to prevent delayed language development (C)

There is no consistently demonstrated association between OME and language outcomes, and substantial variability measurements of exposure and outcome.

Link to Recommendation Statement of this review

Link to Full Technical Report (in pdf)

Link to Structured Abstract of this review

Link to Selected References list of this review

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MANEUVER	EFFECTIVENESS	LEVEL OF EVIDENCE <REF>	RECOMMENDATION
Screening to identify children with clinically important OME (tympanometry, microtympanometry, acoustic reflectometry and pneumo-otoscopy)	Performance of various manoeuvres has not been adequately assessed in community settings. No single reading can give an indication of chronicity which is crucial in a condition which is fluctuating and often self-limiting.	Cohort (II-2) <Multiple studies>	There is insufficient evidence to include routine early screening for otitis media with effusion (OME) in, or exclue it from, the periodic health examination of children up to 4 years of age (C)
Screening to prevent delay in language development as a result of OME	No effect on language was identified in a trial that screened children, then randomly assigned those with persistent effusion to be treated with ventilation tubes (versus usual care, delayed surgery or watchful waiting).	Randomized controlled trial (I), Cohort (II-2) <69-71>	There is insufficient evidence to recommend early screening for OME to prevent delayed language development (C)
	There is no consistently demonstrated association between OME and language outcomes, and substantial variability measurements of exposure and outcome.