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

Figures & data

Figure 1.  Flow chart of the patients and their acoustic reflectometry (AR) recordings in the present study: Percentages calculated both among successful AR recordings and among all studied ears.*

Table I.  Consumer model acoustic reflectometry (AR) results achieved by parents when screening for middle-ear fluid (MEF) among pre-school children (<7 years), categorized by middle-ear status.¹

		Middle-ear status^1
AR test result according to manufacturer-stated risk groups of MEF	AR result categorized (1–5) as growing risk of MEF	MEF^2	No MEF
	5 (n = 28, 19%)	24 (86%)	4 (14%)
Red colour code, “Consult doctor”	4 (n = 11, 7%)	7 (64%)	4 (36%)
	3 (n = 9, 6%)	7 (78%)	2 (22%)
Yellow colour code, “Monitor”	2 (n = 35, 24%)	12 (34%)	23 (66%)
Green colour code, “Fluid unlikely”	1 (n = 38, 26%)	3 (8%)	35 (92%)
Error^3	(n = 27, 18%)	4 (15%)	23 (85%)
Total	(n = 148)	57 (39%)	91 (61%)

Notes: ¹Otomicroscopic myringotomy and suction in general anaesthesia. ²Mucous (glue ear) in 47 (82%), serous in 9 (16%), purulent (acute otitis media) in 1 (2%). ³Error explained by otomicroscopy in five (19%) cases: two patent grommets, one tympanic membrane perforation, two ear canals blocked by cerumen.

Table II.  Sensitivity, specificity, and positive and negative predictive values of consumer model acoustic reflectometry (AR) in hands of parents in detecting of middle ear fluid (MEF) among pre-school (<7 years) children using two different cut-off points.

AR test results according to manufacturer-stated risk groups of MEF (and AR scores)	Sensitivity% (95% CI)	Specificity% (95% CI)	Positive predictive value PPV% (95% CI)	Negative predictive value NPV% (95% CI)
Red^1 colour (3–5) vs. Yellow^2 and green^3 colour (1–2)	72 (59–84)	85 (77–94)	79 (69–90)	79 (70–89)
Red^1 and yellow^2 colour (2–5) vs. Green^3 colour (1)	94 (88–100)	51 (39–64)	60 (49–71)	92 (83–100)

Notes: CI = confidence interval. ¹High probability of middle-ear fluid. Categories 3–5 in Ear Check Middle Ear Monitor™, “Consult doctor”. ² Moderate probability of middle-ear fluid. Category 2 in Ear Check Middle Ear Monitor™, “Monitor”. ³Low probability of middle-ear fluid, healthy ear. Category 1 in Ear Check Middle Ear Monitor™, “Fluid unlikely”.