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The review was registered on PROSPERO (ID: CRD42020128957) and conducted in accordance with PRISMA guidelines.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Seventy articles, including 2274 patients were included in the final synthesis. Seventy\u2010three percent were retrospective case series; the remainder were of low methodological quality. Case definitions varied widely. Median patient age was 69.2\u2009years; 68% were male, 84% had diabetes and 10% had no reported immunosuppressive risk factor. Otalgia was almost universal (96%), with granulation (69%) and oedema (76%) the commonest signs reported.\n                      <jats:italic>Pseudomonas aeruginosa<\/jats:italic>\n                      was isolated in 62%, but a range of bacterial and fungal pathogens were reported and 14% grew no organism. Optimal imaging modality for diagnosis or follow\u2010up was unclear. Median antimicrobial therapy duration was 7.2\u2009weeks, with no definitive evidence for optimal regimens. Twenty\u2010one percent had surgery with widely variable timing, indication, or procedure. One\u2010year disease\u2010specific mortality was 2%; treatment failure and relapse rates were 22% and 7%, respectively.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>There is a lack of robust, high\u2010quality data to support best practice for diagnosis and management for this neglected condition. A minimum set of reporting requirements is proposed for future studies. A consensus case definition is urgently needed to facilitate high\u2010quality research.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1111\/coa.14041","type":"journal-article","created":{"date-parts":[[2023,2,9]],"date-time":"2023-02-09T23:09:15Z","timestamp":1675984155000},"page":"381-394","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":37,"title":["Systematic review of the diagnosis and management of necrotising otitis externa: Highlighting the need for high\u2010quality research"],"prefix":"10.1111","volume":"48","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-0625-3215","authenticated-orcid":false,"given":"Junko","family":"Takata","sequence":"first","affiliation":[{"name":"Department of Infectious Diseases Northwick Park Hospital, London North West University Healthcare NHS Trust  London UK"},{"name":"Infectious Diseases Data Observatory, Centre for Tropical Medicine and Global Health University of Oxford  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