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Can trained nurses exclude acute otitis media with tympanometry or acoustic reflectometry in symptomatic children?
Objective Since acute otitis media (AOM) is the most prevalent bacterial infection in young children, the reliable exclusion of AOM by nurses might save physicians’ time for other duties. The study aim was to determine whether nurses without otoscopic experience can reliably use tympanometry or spec...
Autores principales: | , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Taylor & Francis
2015
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4750740/ https://www.ncbi.nlm.nih.gov/pubmed/26651157 http://dx.doi.org/10.3109/02813432.2015.1118835 |
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author | Laine, Miia K. Tähtinen, Paula A. Ruuskanen, Olli Löyttyniemi, Eliisa Ruohola, Aino |
author_facet | Laine, Miia K. Tähtinen, Paula A. Ruuskanen, Olli Löyttyniemi, Eliisa Ruohola, Aino |
author_sort | Laine, Miia K. |
collection | PubMed |
description | Objective Since acute otitis media (AOM) is the most prevalent bacterial infection in young children, the reliable exclusion of AOM by nurses might save physicians’ time for other duties. The study aim was to determine whether nurses without otoscopic experience can reliably use tympanometry or spectral gradient acoustic reflectometry (SG-AR) to exclude AOM. Design Three nurses were trained, who performed examinations with tympanometry and SG-AR. Pneumatic otoscopy by the study physician served as the diagnostic standard. Setting Study clinic at primary health care level. Patients. 281 children 6–35 months of age. Main outcome measures Predictive values (with 95% confidence interval) for tympanometry and SG-AR, and the clinical usefulness, i.e. the proportion of visits where nurses obtained the exclusive test result from both ears of the child. Results At 459 visits, the negative predictive value of type A and C1 tympanograms (tympanometric peak pressure >–200 daPa) was 94% (91–97%). Based on type A and C1 tympanograms, the nurse could exclude AOM at 94/459 (20%) of visits. The negative predictive value of SG-AR level 1 result (>95°) was 94% (89–97%). Based on the SG-AR level 1 result, the nurse could exclude AOM at 36/459 (8%) of visits. Conclusion KEY POINTS: Acute otitis media (AOM) is the most prevalent bacterial infection in young children. Nurses’ role in excluding AOM is unknown. Type A and C1 tympanograms (tympanometric peak pressure >–200 daPa) obtained by nurses are reliable test results in excluding AOM. With type A and C1 tympanograms, nurses could exclude AOM only at one-fifth of the symptomatic visits. The clinical usefulness of the exclusion of AOM performed by nurses seems to be limited. |
format | Online Article Text |
id | pubmed-4750740 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2015 |
publisher | Taylor & Francis |
record_format | MEDLINE/PubMed |
spelling | pubmed-47507402016-03-02 Can trained nurses exclude acute otitis media with tympanometry or acoustic reflectometry in symptomatic children? Laine, Miia K. Tähtinen, Paula A. Ruuskanen, Olli Löyttyniemi, Eliisa Ruohola, Aino Scand J Prim Health Care Research Articles Objective Since acute otitis media (AOM) is the most prevalent bacterial infection in young children, the reliable exclusion of AOM by nurses might save physicians’ time for other duties. The study aim was to determine whether nurses without otoscopic experience can reliably use tympanometry or spectral gradient acoustic reflectometry (SG-AR) to exclude AOM. Design Three nurses were trained, who performed examinations with tympanometry and SG-AR. Pneumatic otoscopy by the study physician served as the diagnostic standard. Setting Study clinic at primary health care level. Patients. 281 children 6–35 months of age. Main outcome measures Predictive values (with 95% confidence interval) for tympanometry and SG-AR, and the clinical usefulness, i.e. the proportion of visits where nurses obtained the exclusive test result from both ears of the child. Results At 459 visits, the negative predictive value of type A and C1 tympanograms (tympanometric peak pressure >–200 daPa) was 94% (91–97%). Based on type A and C1 tympanograms, the nurse could exclude AOM at 94/459 (20%) of visits. The negative predictive value of SG-AR level 1 result (>95°) was 94% (89–97%). Based on the SG-AR level 1 result, the nurse could exclude AOM at 36/459 (8%) of visits. Conclusion KEY POINTS: Acute otitis media (AOM) is the most prevalent bacterial infection in young children. Nurses’ role in excluding AOM is unknown. Type A and C1 tympanograms (tympanometric peak pressure >–200 daPa) obtained by nurses are reliable test results in excluding AOM. With type A and C1 tympanograms, nurses could exclude AOM only at one-fifth of the symptomatic visits. The clinical usefulness of the exclusion of AOM performed by nurses seems to be limited. Taylor & Francis 2015-12 2015-12-10 /pmc/articles/PMC4750740/ /pubmed/26651157 http://dx.doi.org/10.3109/02813432.2015.1118835 Text en © 2015 The Author(s). 2015 http://creativecommons.org/licenses/by-nc/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial License (http://creativecommons.org/licenses/by-nc/4.0/), which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited. |
spellingShingle | Research Articles Laine, Miia K. Tähtinen, Paula A. Ruuskanen, Olli Löyttyniemi, Eliisa Ruohola, Aino Can trained nurses exclude acute otitis media with tympanometry or acoustic reflectometry in symptomatic children? |
title | Can trained nurses exclude acute otitis media with tympanometry or acoustic reflectometry in symptomatic children? |
title_full | Can trained nurses exclude acute otitis media with tympanometry or acoustic reflectometry in symptomatic children? |
title_fullStr | Can trained nurses exclude acute otitis media with tympanometry or acoustic reflectometry in symptomatic children? |
title_full_unstemmed | Can trained nurses exclude acute otitis media with tympanometry or acoustic reflectometry in symptomatic children? |
title_short | Can trained nurses exclude acute otitis media with tympanometry or acoustic reflectometry in symptomatic children? |
title_sort | can trained nurses exclude acute otitis media with tympanometry or acoustic reflectometry in symptomatic children? |
topic | Research Articles |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4750740/ https://www.ncbi.nlm.nih.gov/pubmed/26651157 http://dx.doi.org/10.3109/02813432.2015.1118835 |
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