Hostname: page-component-586b7cd67f-r5fsc Total loading time: 0 Render date: 2024-11-24T14:08:01.106Z Has data issue: false hasContentIssue false
  • English
  • Français

Can meta-analysis help uncertainty in surgery for otitis media in children

Published online by Cambridge University Press:  29 June 2007

Elizabeth E. Bodner ,
George G. Browning ,
Frances T. Chalmers  and
Thomas C. Chalmers
Elizabeth E. Bodner
Affiliation:
From: Tufts University School of Medicine, Boston, Massachussetts.
George G. Browning*
Affiliation:
Department of Otolaryngology, Royal Infirmary, Glasgow.
Frances T. Chalmers
Affiliation:
Skagut Pediatrics, Seattle, Washington.
Thomas C. Chalmers
Affiliation:
Technology Assessment Group, Harvard School of Public Health, Boston, Massachussetts
*
University of Glasgow, Department of Otolaryngology, Royal Infirmary, Glasgow
Get access Rights & Permissions [Opens in a new window]

Abstract

While otitis media is perhaps the most common disease of childhood that receives medical attention, there is little agreement concerning the efficacy of the medical and surgical therapies employed to try to alleviate its symptoms or hasten its natural resolution. Because various surgeries including adenoidectomy, myringotomy, and insertion of tympanostomy tubes are frequently involved in the treatment of otitis media with effusion (OME), it is likely the most expensive condition being managed in national terms.

In an attempt to elucidate the most appropriate management of this condition, a meta-analysis was attempted to the 12 randomized control trials of surgical treatments for OME in children, published between 1966 and 1990. Heterogeneity both in the populations and comparisons studied and in the out comes presented made meta-analysis an inappropriate method for clarifying this area of clinical uncertainty. Important elements in the design of randomized control trials that should be included in future studies of treatment for OME are therefore discussed.

Keywords

Otitis media with effusionStatisticsmeta-analysis
Type
Main Articles
Information
The Journal of Laryngology & Otology , Volume 105 , Issue 10 , October 1991 , pp. 812 - 819
Copyright
Copyright © JLO (1984) Limited 1991

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

References

Black, N. A., Sanderson, C. F. B., Freeland, A. P., Vessey, M. P. (1990) A randomized controlled trial of surgery for glue ear. British Medical Journal 300: 1551–1556.CrossRefGoogle ScholarPubMed
Bluestone, C. D. (1983) Treatment of otitis media with effusion. Scandinavian Journal of Infectious Diseases, Supplement 39: 26–33.Google ScholarPubMed
Bluestone, C. D. (1989) Two interpretations of drug trial data. Lancet 2: (8661): 507–508.CrossRefGoogle ScholarPubMed
Bluestone, C. D., Cantekin, E. L. (1979) Design factors in the characterization and identification of otitis media and certain related conditions. Annals of Otology, Rhinology and Largynology, Supplement 88: 13–28.CrossRefGoogle ScholarPubMed
Bonding, P., Tos, M. (1985) Grommets versus paracentesis in secretory otitis media. A prospective, controlled study. American Journal of Otology 6: 455–460.Google ScholarPubMed
Brown, M. J., Richards, S. H., Ambegaokar, A. G. (1978) Grommets and glue ear: A five-year follow up of a controlled trial. Journal of the Royal Society of Medicine 71: 353–356.CrossRefGoogle ScholarPubMed
Bulman, C. H., Brook, S. J., Berry, M. G. (1984) A prospective randomized trial of adeniodectomy versus grommet insertion in the treatment of glue ear. Clinical Otolaryngology 9: 67–75.CrossRefGoogle Scholar
Chalmers, T. C., Berrier, J., Sacks, H. S., Levin, H., Reitman, J., Nagalingam, R. (1987) Meta-analysis of clinical trials as a scientific disciplinc. II. Replicate variability and comparison of studies that agree and disagree. Statistics in Medicine 6: 733–744.CrossRefGoogle ScholarPubMed
Chalmers, T. C., Levin, H., Sacks, H. S., Reitman, D., Berrier, J., Nagalingam, R. (1987) Meta-analysis of clinical trials as a scientific discipline. I. Control of bias and comparison with large cooperative trials. Statistics in Medicine 6: 315–325.CrossRefGoogle Scholar
Chalmers, T. C., Smith, H., Blackburn, B., Silverman, B., Schroeder, B., Reitman, D., Ambroz, A. (1981) A method for assessing the quality of a randomized control trial. Controlled Clinical Trials 2: 31–49.CrossRefGoogle ScholarPubMed
Fiellau-Nikolajsen, M. (1983) Tympanometry and secretory otitis media: Observations on diagnosis, epidemiology, treatment and prevention in prospective cohort studies of three year old children. Acta Otolaryngologica, Supplement 394: 1–73.CrossRefGoogle ScholarPubMed
Frenkel, M. (1987) Acute otitis media–does therapy alter its course? Postgraduate Medicine, 82: 84–86.CrossRefGoogle ScholarPubMed
Gates, G. A., Avery, C. A., Cooper, J. C., Prihoda, T. J. (1989) Chronic secretory otitis media: Effects of surgical management. Annals of Otology Rhinology and Laryngology, Supplement 138: 2–32.CrossRefGoogle ScholarPubMed
GISSI Grupo Italiano per lo Studio della Streptochinasi nell' Infarto Miocardio (1986) Effectiveness of intravenous thrombolytic treatment in acute myocardial infarction. Lancet 1: 397–402.Google Scholar
GISSI Gruppo Italiano per lo Studio della Streptochinasi nell' Infarto Miocardico (1987) Long-term effects of intravenous thrombolysis in acute myocardial infarction: final report of the GISSI study. Lancet 2: 871–874.Google Scholar
Glass, C. V. (1976) Primary, secondary, and meta-analysis of research. Educational Research 5: 3–8.CrossRefGoogle Scholar
ISIS-2 (Second International Study of Infarct Survival) Collaborative Group (1988) Randomized trial of intravenous strcptokinase, oral aspirin, both, or neither among 17.187 cases of suspected acute myocardial infarction: ISIS-2. Lancet 2: 349–360.Google Scholar
Liberati, A., Himcl, H. N., Chalmers, T. C. (1986) A quality assessment of randomized control trials of primary treatment of breast cancer. Journal of Clinical Oncology 4: 942–951.CrossRefGoogle ScholarPubMed
Light, R. J.. Smith, P. V. (1971) Accumulating evidence: Procedures for resolving contradictions among different research studies. Harvard Educational Review 42: 429.CrossRefGoogle Scholar
Lildholdt, T. (1983) Ventilation tubes in secretory otitis media. A randomized, controlled study of the course, the complications, and the sequelac of ventilation tubes. Acta Otolaryngologica, Supplement 398: 1–28.CrossRefGoogle Scholar
Mandel, E. M., Rockette, H. E., Bluestone, C. D., Paradise, J. L.. Nozza, R. J. (1989) Myringotomy with and without tympanostomy tubes for chronic otitis media with effusion. Archives of Otolaryngology Head Neck Surgery 115: 1217–1224.CrossRefGoogle ScholarPubMed
Maw, A. R., Parker, A. (1988) Surgery of the tonsils and adenoids in relation to secretory otitis media in children. Ada Otolarvngologica, Supplement 454: 202–207.Google ScholarPubMed
Roydhouse, N. (1980) Adenoidcctomy for otitis media with mucoid effusion. Annals of Otology Rhinology and Laryngology, Supplement 89: 312–315.CrossRefGoogle ScholarPubMed
Ruckley, R. W., Blair, R. L. (1988) Thermal myringotomy (an alternative to grommet insertion in childhood secretory otitis media?). Journal of Laryngology and Otology 102: 125–128.CrossRefGoogle ScholarPubMed
Stampfer, M. J., Goldhaber, S. Z., Yusuf, S., Peto, R., Hennekens, C. H. (1982) Effect of intravenous streptokinase on acute myocardial infarction: Pooled results from randomized trials. New England Journal of Medicine 307: 1180–1182.CrossRefGoogle ScholarPubMed
Tos, S. Panor, A. L., Robin, P. E. (1984) A prospective trial of unilateral grommets for bilateral secretory otitis media in children. Clinical Otolaryngology 9: 115–117.Google Scholar
Widemar, L., Svensson, C., Rynnel-Dagoo, B., Schiratzki, H. (1985) The effect of adenoidectomy on secretory otitis media: A two-year controlled prospective study. Clinical Otolaryngology 10(6): 345–350.CrossRefGoogle Scholar
Yusuf, S., Collins, R., Peto, R., Furberg, C., Stampfer, M. J., Goldhaber, S. Z., Hennekens, C. H. (1985) Intravenous and intracoronary fibrinolytic therapy in acute myocardial infarction: Overview of results on mortality, reinfarction and side effects from 33 randomized controlled trials. European Heart Journal 6: 556–585.CrossRefGoogle ScholarPubMed
Zielhuis, G. A.. Rach, G. H.. van den Broek, P. (1989) Screening for otitis media with effusion in preschool children. Lancet, 311–314.CrossRefGoogle ScholarPubMed