Study designs of evaluations included in the review
Meta-analyses, RCTs, cohorts and audits were included in the review of screening effectiveness. The review of treatment effectiveness included meta-analyses and RCTs. Only studies that included assessment by tympanometry, reported adequate demographic details about the study participants and had generalisability to the New Zealand population were included. Studies had to include more than 30 participants.
Specific interventions included in the review
Screening tests for Otitis media with effusion (OME):
Treatments for OME included: long-course antibiotic therapy (regime not stated); antibiotic prophylaxis (20mg/kg/day amoxicillin); surgical treatment (myringotomy, grommet insertion, adenoidectomy and tonsillectomy); s-carboxymethylcysteine (SCMC) and the monohydrate salt (SCMC-LYS)(regime not stated); nose blowing; autoinflation (Valsalva manoeuvre and Politzerization); steroids (regime not stated); and decongestants (regime not stated).
Reference standard test against which the new test was compared
The review did not include any diagnostic accuracy studies that compared the performance of the index test with a reference standard of diagnosis.
Participants included in the review
Children predominantly between the ages of 0-7yrs (actual range 0-12yrs). Studies examining the effectiveness of treatments included children with OME.
Outcomes assessed in the review
Studies of screening effectiveness assessed health outcomes such as language Reynell Developmental Language Scales for verbal expression and comprehension); hearing test pass/failure rate; and number of cases of confirmed hearing impairment (as assessed by tympanography, audiometry etc).
Studies of treatment effectiveness assessed the resolution rate of OME (over short, intermediate and long term); recurrence rate; and mean hearing improvement (as assessed by tympanography, audiometry etc). One study used a developmental outcome measure the Reynell Developmental Language Scale.
How were decisions on the relevance of primary studies made?
The authors do not state how the papers were selected for the review, or how many of the authors performed the selection.