Comparison of tympanometry and otoscopy in establishing pass/fail referral criteria

Impedance tests, pure tone screening, and pneumatic otoscopy were performed on two groups of children. For the second group, two physicians, one an otolaryngologist and the other a pediatrician, performed the otoscopic examination. Agreement between tympanometry and otoscopy was not influenced by the presence or absence of acoustic reflexes or passing or failing the pure tone screening, but did depend on the criteria used in classifying the tympanograms. Tympanograms classified as having significant negative pressure were those showing the poorest agreement between tympanometry and otoscopy. Between examiners, agreement in otoscopic findings was generally poor. Results are discussed as they apply to establishing pass/fail criteria for screening with impedance.