Abstract
Existing efficacy evidence indicating surgical intervention for otitis media with effusion (OME) urgently needs to be supplemented with effectiveness evidence. In the course of a multi-centre trial to obtain this evidence, large numbers of ENT paediatric otology referrals have been analysed in seven centres. The audiometric entry criteria (≥20 dB HL on two occasions 3 months apart) is the same as in the AHCPR-US guidelines. Only 20% of referrals meet the trial criteria at ENT, lower than may be expected. This may be due to low specificity of GP and community referrals, combined with variable delays to outpatient consultation. A 50% remission rate after 3 months was confirmed in children previously meeting the criteria. These figures are relatively homogeneous across centres. Detailed characteristics of those not meeting trial entry criteria are available from two centres. We conclude that overall cost-effective practice requires a better understanding of the risk factors that cause persistent OME to enable more specific referrals to be made to ENT departments.
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