Journal article
Tubes, antibiotic prophylaxis, or watchful waiting: a decision analysis for managing recurrent acute otitis media
The Journal of family practice, Vol.46(4), pp.304-310
04/01/1998
PMID: 9564372
Abstract
BACKGROUNDThe two most frequently used options to reduce the occurrence of acute otitis media (AOM) are tympanostomy tubes and prophylactic antibiotics. The goal of this study was to create a decision model to identify which intervention, if any, is preferred from the perspective of parents with young children.METHODSWe developed a decision analysis model based on probabilities obtained from the literature and outcome disutilities obtained by interviewing parents. These parameters were placed into the model along with the anticipated number of episodes of AOM a child was expected to have in the coming year without intervention. Sensitivity analyses were performed on the effectiveness of the interventions, the disutilities (burdens associated with specific outcomes or interventions) associated with the interventions, and the characteristics of AOM episodes that the child would experience without any intervention.RESULTSThirty-seven parents with young children were interviewed for this project. The preferred intervention for a child was sensitive to the number of episodes of AOM the child was anticipated to have in the coming year, the percentage of these episodes predicted to be severe, and how parents rated tympanostomy tubes compared with prophylactic antibiotics. In our base case of four episodes of AOM in the coming year (two mild episodes and two severe episodes), we found that tympanostomy tubes resulted in the best average outcome. Under different patient conditions, however, the preferred strategy could be either the use of prophylactic antibiotics or watchful waiting.CONCLUSIONSIn our base case, the model suggested that tympanostomy tubes were preferable to prophylactic antibiotics. However, there is no single preferred preventive intervention for all children with recurrent AOM because of variation in the character of infections and the values parents give to the potential outcomes.
Details
- Title: Subtitle
- Tubes, antibiotic prophylaxis, or watchful waiting: a decision analysis for managing recurrent acute otitis media
- Creators
- G R BergusM M Lofgren
- Resource Type
- Journal article
- Publication Details
- The Journal of family practice, Vol.46(4), pp.304-310
- PMID
- 9564372
- ISSN
- 0094-3509
- eISSN
- 1533-7294
- Language
- English
- Date published
- 04/01/1998
- Academic Unit
- Physician Assistant Studies; Psychiatry; Family and Community Medicine
- Record Identifier
- 9984280840502771
Metrics
6 Record Views