Critical appraisal of clinical practice guidelines for otitis media in Asian and Western countries with consideration of updates: A narrative review.

Abstract

Introduction: Acute otitis media is a common disease in children under the age of 5 years due to their primitive ear anatomy. One of its consequences is otitis media with effusion (OME), which is a condition wherein serous secretion accumulates in the middle ear due to Eustachian tube dysfunction. OME results in conductive hearing loss, impacting children's learning and development. This review aimed to identify discrepancies in clinical practice guidelines (CPGs) for managing OME in children across Asian and Western countries, focusing on updates to these guidelines.

Methods: A comparative review involving critical appraisal using the Appraisal of Guidelines for Research and Evaluation II tool was conducted. CPGs for managing ear effusion in children in Western and Asian countries published in the PubMed, Cochrane Library, Scopus and Science Direct databases were reviewed. Four CPGs from Western countries (Scotland, England, the United States of America and France) and three CPGs from Asian countries (Japan, Korea and Malaysia) were selected.

Results: There was a mild discrepancy regarding conducting surgery after 3 months, particularly myringotomy and adenoidectomy with or without grommets, between the Scottish CPG and other CPGs.

Conclusion: Asian CPGs for the management of OME share many similarities with Western CPGs. However, Asian CPGs tend to be stronger in most domains and levels of evidence. Japanese and American CPGs are up to date as of 2022 and 2016, respectively, while other CPGs are outdated for about 10 years.