{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,6]],"date-time":"2026-07-06T04:25:11Z","timestamp":1783311911766,"version":"3.54.6"},"reference-count":47,"publisher":"Wiley","issue":"S2","license":[{"start":{"date-parts":[[2017,6,29]],"date-time":"2017-06-29T00:00:00Z","timestamp":1498694400000},"content-version":"vor","delay-in-days":28,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Orthod Craniofacial Res"],"published-print":{"date-parts":[[2017,6]]},"abstract":"<jats:title>Structured Abstract<\/jats:title><jats:sec><jats:title>Objectives<\/jats:title><jats:p>To explore centre\u2010level variation in otitis media with effusion (<jats:styled-content style=\"fixed-case\">OME<\/jats:styled-content>), hearing loss and treatments in children in Cleft Care <jats:styled-content style=\"fixed-case\">UK<\/jats:styled-content> (<jats:styled-content style=\"fixed-case\">CCUK<\/jats:styled-content>) and to examine the association between <jats:styled-content style=\"fixed-case\">OME<\/jats:styled-content>, hearing loss and developmental outcomes at 5 and 7\u00a0years.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting and Sample Population<\/jats:title><jats:p>Two hundred and sixty\u2010eight 5\u2010year\u2010old British children with non\u2010syndromic unilateral cleft lip and palate (<jats:styled-content style=\"fixed-case\">UCLP<\/jats:styled-content>) recruited to <jats:styled-content style=\"fixed-case\">CCUK<\/jats:styled-content>.<\/jats:p><\/jats:sec><jats:sec><jats:title>Materials and Methods<\/jats:title><jats:p>Children had air and bone conduction audiometry at age 5. Information on grommet and hearing aid treatment was obtained from parental questionnaire and medical notes. Hearing loss at age 5 was defined as &gt;20 <jats:styled-content style=\"fixed-case\">dB<\/jats:styled-content> in the better ear and history of <jats:styled-content style=\"fixed-case\">OME<\/jats:styled-content> and hearing loss was determined from past treatment. Children with sensorineural hearing loss were excluded. Associations were examined with speech, behaviour and self\u2010confidence at age 5 and educational attainment at age 7. Centre variation was examined using hierarchical models and associations between hearing variables and developmental outcomes were examined using logistic regression.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>There was centre\u2010level variation in early grommet placement (variance partition coefficient (<jats:styled-content style=\"fixed-case\">VPC<\/jats:styled-content>) 18%, <jats:italic>P<\/jats:italic>=.001) and fitting of hearing aids (<jats:styled-content style=\"fixed-case\">VPC<\/jats:styled-content> 8%, <jats:italic>P<\/jats:italic>=.03). A history of <jats:styled-content style=\"fixed-case\">OME<\/jats:styled-content> and hearing loss was associated with poor intelligibility of speech (adjusted odds ratio=2.87, 95% <jats:styled-content style=\"fixed-case\">CI<\/jats:styled-content> 1.42\u20105.77) and aspects of educational attainment.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Hearing loss is an important determinant of poor speech and treatment variation across centres suggest management of <jats:styled-content style=\"fixed-case\">OME<\/jats:styled-content> and hearing loss could be improved.<\/jats:p><\/jats:sec>","DOI":"10.1111\/ocr.12184","type":"journal-article","created":{"date-parts":[[2017,6,29]],"date-time":"2017-06-29T09:15:12Z","timestamp":1498727712000},"page":"8-18","source":"Crossref","is-referenced-by-count":19,"title":["Centre\u2010level variation in outcomes and treatment for otitis media with effusion and hearing loss and the association of hearing loss with developmental outcomes at ages 5 and 7\u00a0years in children with non\u2010syndromic unilateral cleft lip and palate: The Cleft Care <scp>UK<\/scp> study. Part 2"],"prefix":"10.1111","volume":"20","author":[{"given":"A.","family":"Hall","sequence":"first","affiliation":[{"name":"Life and Health Sciences Aston University  Birmingham UK"},{"name":"Children's Hearing Centre St Michael's Hospital  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A. K.","family":"Wills","sequence":"additional","affiliation":[{"name":"National Institute for Health Research (NIHR) Biomedical Research Unit in Nutrition Diet and Lifestyle at the University Hospitals Bristol NHS Foundation Trust and the University of Bristol  Bristol UK"},{"name":"Bristol Dental School University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"O.","family":"Mahmoud","sequence":"additional","affiliation":[{"name":"School of Social and Community Medicine University of Bristol  Clifton Bristol UK"},{"name":"Department of Applied Statistics Helwan University  Cairo Egypt"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"D.","family":"Sell","sequence":"additional","affiliation":[{"name":"North Thames Regional Cleft Service Speech and Language Therapy Department and Centre for Outcomes and Experience Research in Children's Health, Illness and Disability (ORCHID) Great Ormond Street Hospital NHS Foundation Trust  London UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"Waylen","sequence":"additional","affiliation":[{"name":"Bristol Dental School University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"S.","family":"Grewal","sequence":"additional","affiliation":[{"name":"Bristol Dental School University of Bristol  Bristol UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"J. 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