Aggregate evidence quality | Grade B |
Benefits | Reduces overdiagnosis and unnecessary treatment. Increases correct diagnosis of other conditions with symptoms that otherwise might be attributed to AOM. Promotes the use of pneumatic otoscopy and tympanometry to improve diagnostic accuracy. |
Risks, harms, cost | Cost of tympanometry. Need to acquire or reacquire skills in pneumatic otoscopy and tympanometry for some clinicians. |
Benefits-harms assessment | Preponderance of benefit. |
Value judgments | AOM is overdiagnosed, often without adequate visualization of the TM. Early AOM without effusion occurs, but the risk of overdiagnosis supersedes that concern. |
Intentional vagueness | None |
Role of patient preferences | None |
Exclusions | Early AOM evidenced by intense erythema of the TM. |
Strength | Recommendation |
Aggregate evidence quality | Grade B |
Benefits | Reduces overdiagnosis and unnecessary treatment. Increases correct diagnosis of other conditions with symptoms that otherwise might be attributed to AOM. Promotes the use of pneumatic otoscopy and tympanometry to improve diagnostic accuracy. |
Risks, harms, cost | Cost of tympanometry. Need to acquire or reacquire skills in pneumatic otoscopy and tympanometry for some clinicians. |
Benefits-harms assessment | Preponderance of benefit. |
Value judgments | AOM is overdiagnosed, often without adequate visualization of the TM. Early AOM without effusion occurs, but the risk of overdiagnosis supersedes that concern. |
Intentional vagueness | None |
Role of patient preferences | None |
Exclusions | Early AOM evidenced by intense erythema of the TM. |
Strength | Recommendation |