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Spectral gradient acoustic reflectometry compared with tympanometry in diagnosing middle ear effusion in children
Jennifer Chianese1, Alejandro Hoberman, Jack L Paradise
1Division of General Academic Pediatrics, Children's Hospital of Pittsburgh, Pittsburgh, PA 15213-2583, USA. jennifer.chianese@chp.edu
Insights
Spectral gradient acoustic reflectometry (SGAR) showed lower accuracy than tympanometry in diagnosing middle ear effusion in young children. SGAR identified only 47% of effusions, while tympanometry performed better in this pediatric age group.
Area of Science:
- Pediatric Otolaryngology
- Diagnostic Accuracy Studies
- Middle Ear Disease
Background:
- Accurate diagnosis of middle ear effusion (MEE) in infants and toddlers is challenging.
- Tympanometry is a common tool, but alternative methods are being explored.
Purpose of the Study:
- To assess the diagnostic accuracy of spectral gradient acoustic reflectometry (SGAR) for middle ear effusion in children aged 6 to 24 months.
- To compare the performance of SGAR against tympanometry in this population.
Main Methods:
- A comparative diagnostic test study was conducted in an urban primary care setting.
- 786 healthy children aged 6 to 24 months were enrolled.
- Sensitivity, specificity, and receiver operating characteristic (ROC) curves were calculated for SGAR and tympanometry.
Main Results:
- SGAR demonstrated a sensitivity of 47% and specificity of 90% for detecting middle ear effusion.
- The area under the ROC curve for SGAR was 0.78, compared to 0.83 for tympanometry.
- Tympanometry showed a higher diagnostic performance than SGAR.
Conclusions:
- Spectral gradient acoustic reflectometry is less accurate than tympanometry for identifying middle ear effusion in children under two years old.
- Tympanometry remains a more reliable method for diagnosing middle ear effusion in this age group.
Objectives:
To evaluate the accuracy of spectral gradient acoustic reflectometry (SGAR) in children aged 6 to 24 months, and to compare SGAR with tympanometry.
Design:
Comparison of diagnostic tests.
Setting:
Inner-city primary care center in Pittsburgh, Pennsylvania.
Participants:
A total of 786 healthy children aged 6 to 24 months.
Main Outcome Measures:
Test characteristics of SGAR (sensitivity, specificity, and positive and negative predictive values) and receiver operating characteristic curves from the SGAR and tympanometric data.
Results:
The SGAR results were available for 3096 otoscopic examinations in 647 children. Tympanometric results were available for 2854 otoscopic examinations in 597 children. Using the recommended SGAR pass or fail cutoff, 53% of the ears in which effusion was present would have been considered effusion free (sensitivity, 47%). Only 10% of the ears without effusion would have been considered to have effusion (specificity, 90%). The area under the receiver operating characteristic curve was 0.78 for SGAR and 0.83 for tympanometry.
Conclusion:
Spectral gradient acoustic reflectometry is slightly less discerning than tympanometry in predicting the presence or absence of middle ear effusion in children younger than 2 years.
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