Clinical Practice Guidelines: Whose Practice Are We Guiding?

Area of Science:

• Otolaryngology
• Primary Care Medicine
• Clinical Practice Guidelines

Background:

• Otitis media with effusion is common and often managed by primary care providers.
• Awareness and utilization of updated American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) clinical practice guidelines (CPGs) for this condition are unknown.
• Existing CPGs may not be consistently adopted in primary care settings.

Purpose of the Study:

• To assess primary care providers' familiarity with otologic diagnoses, evaluation skills, and utilization of AAO-HNSF CPGs for otitis media with effusion.
• To identify gaps in knowledge and practice regarding otitis media management in primary care.
• To evaluate the current adoption rate of specific diagnostic tools like pneumatic otoscopy.

Main Methods:

• A cross-sectional survey was conducted among primary care providers.
• The survey assessed familiarity with otologic diagnoses and evaluation skills.
• Provider utilization of CPGs for otitis media management and tympanostomy tube referral was investigated.

Main Results:

• Only 38.5% of surveyed providers reported using pneumatic otoscopy for diagnosis.
• Approximately 50% of providers utilized a CPG for otitis media management or tympanostomy tube referral.
• The majority of providers predominantly referenced the American Academy of Pediatrics guideline for acute otitis media.

Conclusions:

• Primary care providers demonstrate limited awareness and utilization of the AAO-HNSF CPGs for otitis media with effusion.
• There is a need for enhanced training for primary care providers on otitis media diagnosis and management.
• Recommendations include otolaryngologist-led workshops and integration into medical curricula, alongside improved CPG dissemination via society websites and newsletters.