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Predictive value of parent-reported symptoms in the assessment of otitis media with effusion during infancy
J Engel1, L Anteunis, A Volovics
1Department of Otorhinolaryngology, Head & Neck Surgery, University Hospital Maastricht, The Netherlands.
Insights
Parent-reported symptoms for infant ear infections have limited diagnostic value. Combining multiple reported symptoms can improve accuracy, but their absence does not rule out otitis media with effusion (OME).
Area of Science:
- Pediatrics
- Otolaryngology
- Diagnostic Accuracy
Background:
- Otitis media with effusion (OME) is common in infants.
- Accurate diagnosis is crucial for timely intervention.
- Parental reporting of symptoms is a potential, yet unvalidated, diagnostic aid.
Purpose of the Study:
- To assess the predictive value of parent-reported symptoms for diagnosing OME in infants.
- To compare parental symptom reports with objective middle ear assessments.
Main Methods:
- Prospective longitudinal study of 105 healthy infants from birth to 2 years.
- Parental symptom questionnaires (ear infection, hearing loss, mouth breathing, snoring, common cold) compared with otoscopy and tympanometry.
- Analysis of sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV).
Main Results:
- OME prevalence ranged from 39%-53%.
- Common cold showed high sensitivity (83%) but low specificity (36%).
- Hearing loss had the highest PPV (70%), while combined symptoms increased diagnostic validity.
Conclusions:
- Parental reports of ear infection, hearing loss, and common cold have limited diagnostic value for OME.
- While symptom combinations enhance diagnostic validity, their absence does not exclude OME.
- Objective measures remain essential for accurate OME diagnosis in infants.
Objective:
To determine the predictive value of parent-reported symptoms in the assessment of otitis media with effusion (OME) during infancy.
Design:
Prospective longitudinal study that compared the results of questionnaire-based parental reports with the state of the middle ear assessed by otoscopy and tympanometry at 3-month intervals from birth to the age of 2 years.
Setting:
Outpatient Department, University Hospital Maastricht, The Netherlands.
Subjects:
One hundred and fifth healthy-born infants.
Main Outcome Measures:
Sensitivity, specificity, positive and negative predictive values of parent-reported ear infection, hearing loss, mouth breathing, snoring and common cold.
Results:
Prevalence rates showed the following ranges: OME, 39%-53%, parent-reported ear infection, 2%-20%, hearing loss 2%-7%, mouth breathing, 30%-41%, snoring, 31%-41% and common cold, 65%-81%. Common cold demonstrated the highest sensitivity (83%) with a low specificity of 36%. Hearing loss gave the highest positive predictive value (PPV) (70%) with a moderate negative predictive value (NPV) (54%). PPV increased with the number of anamnese questions answered positively.
Conclusions:
The diagnostic value of parent-reported ear infection, hearing loss and common cold was found to be limited. Combinations of positively-reported symptoms gives increased diagnostic validity while the absence of parent-reported symptoms does not necessarily indicate the absence of OME.
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