Consumer acoustic reflectometry by parents in detecting middle-ear fluid among children undergoing tympanostomy

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-Häme 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.

• Acoustic reflectometry
• diagnosis
• middle-ear fluid
• otitis media
• sensitivity
• specificity