{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T07:32:43Z","timestamp":1793950363798,"version":"4.8.0"},"reference-count":41,"publisher":"Cambridge University Press (CUP)","issue":"9","license":[{"start":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T00:00:00Z","timestamp":1713744000000},"content-version":"unspecified","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J. Laryngol. Otol."],"published-print":{"date-parts":[[2024,9]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:sec id=\"S0022215124000513_sec_a1\"><jats:title>Objective<\/jats:title><jats:p>Evidence for necrotising otitis externa (NOE) diagnosis and management is limited, and outcome reporting is heterogeneous. International best practice guidelines were used to develop consensus diagnostic criteria and a core outcome set (COS).<\/jats:p><\/jats:sec><jats:sec id=\"S0022215124000513_sec_a2\" sec-type=\"methods\"><jats:title>Methods<\/jats:title><jats:p>The study was pre-registered on the Core Outcome Measures in Effectiveness Trials (COMET) database. Systematic literature review identified candidate items. Patient-centred items were identified via a qualitative study. Items and their definitions were refined by multidisciplinary stakeholders in a two-round Delphi exercise and subsequent consensus meeting.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215124000513_sec_a3\" sec-type=\"results\"><jats:title>Results<\/jats:title><jats:p>The final COS incorporates 36 items within 12 themes: Signs and symptoms; Pain; Advanced Disease Indicators; Complications; Survival; Antibiotic regimes and side effects; Patient comorbidities; Non-antibiotic treatments; Patient compliance; Duration and cessation of treatment; Relapse and readmission; Multidisciplinary team management.<\/jats:p><jats:p>Consensus diagnostic criteria include 12 items within 6 themes: Signs and symptoms (oedema, otorrhoea, granulation); Pain (otalgia, nocturnal otalgia); Investigations (microbiology [does not have to be positive], histology [malignancy excluded], positive CT and MRI); Persistent symptoms despite local and\/or systemic treatment for at least two weeks; At least one risk factor for impaired immune response; Indicators of advanced disease (not obligatory but mut be reported when present at diagnosis). Stakeholders were unanimous that there is no role for secondary, graded, or optional diagnostic items. The consensus meeting identified themes for future research.<\/jats:p><\/jats:sec><jats:sec id=\"S0022215124000513_sec_a4\" sec-type=\"conclusions\"><jats:title>Conclusion<\/jats:title><jats:p>The adoption of consensus-defined diagnostic criteria and COS facilitates standardised research reporting and robust data synthesis. Inclusion of patient and professional perspectives ensures best practice stakeholder engagement.<\/jats:p><\/jats:sec>","DOI":"10.1017\/s0022215124000513","type":"journal-article","created":{"date-parts":[[2024,4,22]],"date-time":"2024-04-22T07:18:23Z","timestamp":1713770303000},"page":"913-920","source":"Crossref","is-referenced-by-count":11,"title":["Diagnostic criteria and core outcome set development for necrotising otitis externa: the COSNOE Delphi consensus study"],"prefix":"10.1017","volume":"138","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-4925-1241","authenticated-orcid":false,"given":"Sirat","family":"Lodhi","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kirsty","family":"Dodgson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"Dykes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veena","family":"Vishwanath","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohit","family":"Bazaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sachin","family":"Mathur","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Glen","family":"Watson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Cartwright","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Amy","family":"Pearson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Deborah","family":"Wearmouth","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Richard","family":"List","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Phillip","family":"Yates","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joanna","family":"Dixon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arullendran","family":"Puveendran","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margarita","family":"Wilson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Katherine","family":"Watson","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Milo","family":"Cullinan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Youssef","family":"Mentias","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ruth","family":"Capper","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Linda","family":"Jewes","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sebastian","family":"Wallis","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"David","family":"Hamilton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Brook","family":"Adams","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mamoona","family":"Khalid-Raja","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Barzo","family":"Faris","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maha","family":"Khan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stefan","family":"Linton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rohma","family":"Abrar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eloise","family":"Owen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vasiliki","family":"Bisbinas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ali","family":"Ijaz","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberley","family":"Lau","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sara","family":"Timms","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jack","family":"Bruce","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7763-9705","authenticated-orcid":false,"given":"Emma","family":"Stapleton","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2024,4,22]]},"reference":[{"key":"S0022215124000513_ref11","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215100101562"},{"key":"S0022215124000513_ref36","doi-asserted-by":"publisher","DOI":"10.1002\/lary.27526"},{"key":"S0022215124000513_ref38","doi-asserted-by":"publisher","DOI":"10.1016\/0021-9681(87)90171-8"},{"key":"S0022215124000513_ref20","doi-asserted-by":"publisher","DOI":"10.1056\/NEJM199909163411207"},{"key":"S0022215124000513_ref34","doi-asserted-by":"publisher","DOI":"10.1007\/s40134-018-0263-y"},{"key":"S0022215124000513_ref10","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215123001664"},{"key":"S0022215124000513_ref29","doi-asserted-by":"publisher","DOI":"10.1007\/s10096-022-04455-y"},{"key":"S0022215124000513_ref35","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215111001691"},{"key":"S0022215124000513_ref23","doi-asserted-by":"publisher","DOI":"10.1007\/s00248-013-0297-x"},{"key":"S0022215124000513_ref25","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000000563"},{"key":"S0022215124000513_ref5","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24726"},{"key":"S0022215124000513_ref26","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-019-05396-7"},{"key":"S0022215124000513_ref31","doi-asserted-by":"publisher","DOI":"10.1001\/archoto.2011.98"},{"key":"S0022215124000513_ref8","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215121003443"},{"key":"S0022215124000513_ref15","volume-title":"The Delphi Method: An Experimental Study of Group Opinion","author":"Dalkey","year":"1969"},{"key":"S0022215124000513_ref39","doi-asserted-by":"publisher","DOI":"10.1016\/j.amjoto.2020.102894"},{"key":"S0022215124000513_ref28","doi-asserted-by":"publisher","DOI":"10.1177\/0194599810396132"},{"key":"S0022215124000513_ref24","first-page":"591714","article-title":"Temporal bone osteomyelitis: the relationship with malignant otitis externa, the diagnostic dilemma, and changing trends","author":"Chen","year":"2014","journal-title":"Scientific World Journal"},{"key":"S0022215124000513_ref12","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2022-061349"},{"key":"S0022215124000513_ref14","doi-asserted-by":"publisher","DOI":"10.1136\/bmj.j2262"},{"key":"S0022215124000513_ref17","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-022-07784-y"},{"key":"S0022215124000513_ref27","first-page":"CD004617","article-title":"Hyperbaric oxygen as an adjuvant treatment for malignant otitis externa","author":"Phillips","year":"2013","journal-title":"Cochrane Database Syst Rev"},{"key":"S0022215124000513_ref40","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0251395"},{"key":"S0022215124000513_ref3","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215121004515"},{"key":"S0022215124000513_ref18","doi-asserted-by":"crossref","first-page":"2261","DOI":"10.1007\/s00405-015-3738-y","article-title":"Malignant otitis externa in a healthy non-diabetic patient","volume":"273","author":"Lui","year":"2016","journal-title":"Eur Arch Otorhinolaryngol"},{"key":"S0022215124000513_ref22","article-title":"Diagnostic value of erythrocyte sedimentation rate and c reactive protein in detecting diabetic foot osteomyelitis","volume":"8","author":"Moallemi","year":"2020","journal-title":"Arch Acad Emerg Med"},{"key":"S0022215124000513_ref32","doi-asserted-by":"publisher","DOI":"10.1177\/0194599813482107"},{"key":"S0022215124000513_ref1","doi-asserted-by":"publisher","DOI":"10.1288\/00005537-196808000-00002"},{"key":"S0022215124000513_ref4","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000002723"},{"key":"S0022215124000513_ref16","doi-asserted-by":"publisher","DOI":"10.1016\/j.jclinepi.2013.12.002"},{"key":"S0022215124000513_ref9","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215121003030"},{"key":"S0022215124000513_ref6","first-page":"425","article-title":"Malignant external otitis: factors predicting patient outcomes","volume":"37","author":"Stern Shavit","year":"2016","journal-title":"Am J Otolaryngol Head Neck Surg"},{"key":"S0022215124000513_ref19","doi-asserted-by":"publisher","DOI":"10.1016\/j.anorl.2012.04.011"},{"key":"S0022215124000513_ref2","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215122002663"},{"key":"S0022215124000513_ref7","doi-asserted-by":"publisher","DOI":"10.1017\/S0022215122000858"},{"key":"S0022215124000513_ref41","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.1000217"},{"key":"S0022215124000513_ref21","doi-asserted-by":"publisher","DOI":"10.1086\/383272"},{"key":"S0022215124000513_ref33","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000001812"},{"key":"S0022215124000513_ref37","first-page":"e20675","article-title":"Necrotising otitis externa: a review of imaging modalities","volume":"13","author":"Khan","year":"2021","journal-title":"Cureus"},{"key":"S0022215124000513_ref30","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000000839"},{"key":"S0022215124000513_ref13","first-page":"280","volume":"18","author":"Williamson","year":"2017","journal-title":"The COMET Handbook, version 1.0. Trials"}],"container-title":["The Journal of Laryngology &amp; Otology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S0022215124000513","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,10,28]],"date-time":"2024-10-28T10:56:14Z","timestamp":1730112974000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S0022215124000513\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,4,22]]},"references-count":41,"journal-issue":{"issue":"9","published-print":{"date-parts":[[2024,9]]}},"alternative-id":["S0022215124000513"],"URL":"https:\/\/doi.org\/10.1017\/s0022215124000513","relation":{},"ISSN":["0022-2151","1748-5460"],"issn-type":[{"value":"0022-2151","type":"print"},{"value":"1748-5460","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,4,22]]}}}