Authors' objectives:

The objective of this report was to undertake a review of research on the effectiveness of preschool and school entrant screening programmes for otitis media with effusion and conductive hearing loss.

Authors' results and conclusions: It was found that otitis media with effusion (OME) is common, but the majority of episodes resolve spontaneously, with only a few going on to be persistent. Risk factors for OME include male gender, low socio-economic status, exposure to tobacco smoke, bottle-feeding and attendance at day-care centres. It is not possible from the current research to either support or refute the case that OME and conductive hearing loss causes disability in children. Treatments such as long-course antibiotic and prophylactic antibiotic therapy may improve the rate of resolution of OME in the short-term only (< 30 days). Grommets and adenoidectomy offer modest improvement in hearing, with an average improvement of 12 dB HL at 6 months and 6 dB HL at 12 months. However, it is not possible to determine whether these treatments alter disability-related outcomes, as this has been inadequately documented in the research. Suitable screening tests are available for OME (tympanometry) and conductive hearing loss (audiometry). However, hearing testing of children under 4 years of age is more difficult.

Authors' recommendations: Screening programmes for OME and conductive hearing loss may vary greatly in the way they are constructed (algorithm) and consequently vary in their sensitivity, specificity, PPV and NPV. This makes it difficult to compare different screening programmes. Only a few studies have examined screening programmes for OME and conductive hearing loss and these were generally deficient in their design. They did not demonstrate screening programmes to be an effective strategy for OME and conductive hearing loss. Unfortunately, it is therefore not possible to conclude from the literature reviewed in this report whether or not screening programmes for OME and conductive hearing loss in preschool and school entrant children are an effective health strategy. More specifically, conclusions cannot be drawn on specific aspects of the current screening programme for OME and conductive hearing loss. Currently no recommendation can be made on high-risk targeted screening, changing the age of screening (either younger or older) or changing the screening interval. It must also be noted that it cannot be concluded that current screening programmes for OME and conductive hearing loss in New Zealand are ineffective. To determine whether screening programmes for OME and conductive hearing loss in preschool and new entrant school children are an effective health strategy, more research is needed. Although research is difficult in this area, a thorough evaluation of New Zealand's screening programme and its outcomes would help determine the best choice for effective health strategies for OME and conductive hearing loss.

Authors' methods: Systematic review

Project Status: Completed

URL for project: http://nzhta.chmeds.ac.nz/publications.htm

Year Published: 1998

English language abstract: An English language summary is available

Publication Type: Not Assigned

Country: New Zealand

Organisation Name: New Zealand Health Technology Assessment

Contact Address: Department of Public Health and General Practice, Christchurch School of Medicine and Health Sciences, University of Otago, P.O. Box 4345, Christchurch, New Zealand. Tel: +64 3 364 1145; Fax: +64 3 364 1152;

Contact Name: nzhta@chmeds.ac.nz

Contact Email: nzhta@chmeds.ac.nz

Copyright: New Zealand Health Technology Assessment