Defining the Terminology for Acute Ear Discharge in Children: Systematic Review and Expert Consensus Using the Nominal Group Technique

IF 1.5 4区医学 Q2 OTORHINOLARYNGOLOGY

Clinical Otolaryngology Pub Date : 2025-08-06 DOI:10.1111/coa.70021

Elliot Heward, James Dempsey, Amy McGovarin, John Molloy, Mark Wilbourn, Eason Sivayoham, Merijam Kikic, Jaya R. Nichani, Iain A. Bruce

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引用次数: 0

Abstract

Background

Acute otitis media (AOM) is one of the most frequent paediatric infections. In approximately 15% of children with AOM, the tympanic membrane perforates, leading to ear discharge. This subset of children is usually more unwell and may need different treatment than those without a perforation. Therefore, terminology is required to differentiate this population from AOM without perforation. Using a consensus exercise, we aimed to standardise disease terminology for this patient group.

Methods

A systematic review was performed using OVID Embase to identify the terminology used within the current published literature. The RAND version of the Nominal Group Technique was then used to gain consensus using an expert panel.

Results

The systematic review identified 2012 abstracts which were reviewed, of which 29 manuscripts were included. A total of nine different definitions were identified within the literature. The expert panel concluded that the terminology ‘acute otitis media with discharge (AOMd)’ should be used when diagnosing a child with an acutely discharging ear of up to 6 weeks duration. Recurrent disease should be diagnosed when four or greater episodes occur per year. Within this disease context, the panel determined the optimal research question was to identify the best management option.

Conclusion

This consensus process has proposed the terminology that should be applied for children with acute ear discharge secondary to AOM. The use of standardised terminology is essential to improve patient care and ensure homogeneity across future research.

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定义儿童急性耳部溢液术语：系统评价和专家共识使用名义组技术。

背景：急性中耳炎（AOM）是最常见的儿科感染之一。在大约15%的急性中耳炎患儿中，鼓膜穿孔导致耳液流出。这部分儿童通常更不舒服，可能需要与没有穿孔的儿童不同的治疗。因此，需要用术语来区分这种人群和没有穿孔的AOM。使用共识练习，我们旨在标准化该患者组的疾病术语。方法：使用OVID Embase进行系统回顾，以确定当前已发表文献中使用的术语。然后使用RAND版本的名义组技术，通过专家小组获得共识。结果：系统综述共纳入文献摘要2012篇，其中纳入29篇。文献中共有九种不同的定义。专家小组得出的结论是，在诊断持续时间长达6周的儿童耳部急性流出性中耳炎时，应使用术语“急性流出性中耳炎（AOMd）”。当每年发生四次或更多次发作时，应诊断为复发性疾病。在这种疾病背景下，专家组确定最佳研究问题是确定最佳管理方案。结论：这一共识过程提出了应适用于急性中耳炎继发的儿童耳流的术语。标准化术语的使用对于改善患者护理和确保未来研究的同质性至关重要。

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来源期刊

Clinical Otolaryngology 医学-耳鼻喉科学

CiteScore

4.00

自引率

4.80%

发文量

106

审稿时长

>12 weeks

期刊介绍： Clinical Otolaryngology is a bimonthly journal devoted to clinically-oriented research papers of the highest scientific standards dealing with: current otorhinolaryngological practice audiology, otology, balance, rhinology, larynx, voice and paediatric ORL head and neck oncology head and neck plastic and reconstructive surgery continuing medical education and ORL training The emphasis is on high quality new work in the clinical field and on fresh, original research. Each issue begins with an editorial expressing the personal opinions of an individual with a particular knowledge of a chosen subject. The main body of each issue is then devoted to original papers carrying important results for those working in the field. In addition, topical review articles are published discussing a particular subject in depth, including not only the opinions of the author but also any controversies surrounding the subject. • Negative/null results In order for research to advance, negative results, which often make a valuable contribution to the field, should be published. However, articles containing negative or null results are frequently not considered for publication or rejected by journals. We welcome papers of this kind, where appropriate and valid power calculations are included that give confidence that a negative result can be relied upon.