A study of clinician adherence to treatment guidelines for otitis media with effusion

WMJ. 2010 Feb;109(1):15-20.


Objectives: This study evaluated clinician compliance with recommendations in the 2004 American Academy of Pediatrics (AAP) guidelines on otitis media with effusion (OME) related to documentation of presence, laterality, resolution, persistence, and surveillance for hearing loss or speech delay.

Methods: Retrospective chart review of 363 children aged 2 months to 12 years diagnosed with OME was performed. An electronic survey was used to measure physician awareness and knowledge of specific recommendations in the 2004 AAP clinical practice guidelines on OME.

Results: We found a high level of documentation practices at the initial diagnosis of OME (laterality 95%) but poor documentation of follow-up factors (duration 14.9%). Documentation was not found to improve after release of the 2004 AAP guidelines. The survey found physician knowledge lacking in terms of the decibel hearing level stratification of management and antibiotic use, although better for the use of pneumatic otoscopy as a primary diagnostic method and adenoidectomy and myringotomy as accepted treatments.

Conclusion: Documentation practices of clinicians studied remained unchanged after release of the 2004 guidelines. More research is needed to delineate reasons for poor adherence of pediatric health care professionals to the 2004 OME guidelines, and ways to enhance communication of guideline changes to practicing health care professionals.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Chi-Square Distribution
  • Child
  • Child, Preschool
  • Documentation
  • Guideline Adherence*
  • Health Knowledge, Attitudes, Practice
  • Humans
  • Infant
  • Otitis Media with Effusion / diagnosis*
  • Practice Patterns, Physicians' / statistics & numerical data
  • Retrospective Studies
  • Wisconsin