{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:42:40Z","timestamp":1761007360014,"version":"build-2065373602"},"reference-count":21,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2015,1,20]],"date-time":"2015-01-20T00:00:00Z","timestamp":1421712000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2015,6]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To use a utility\u2010based Markov decision analysis model to compare outcomes of short\u2010term grommet tympanostomy tubes (TTs), intermediate\u2010type tubes, and permanent T\u2010Tubes and to use a detailed sensitivity analysis to determine the most important factors influencing outcomes with one type of TT versus another.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Markov decision analysis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Hypothetical cohort.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>A Markov cohort decision analysis model was created using computer software (TreeAge Software, Inc, Williamstown, Massachusetts) comparing the 3 types of TT. Published data were used to determine key baseline model parameters. The model featured potential complications including eardrum perforation, early TT extrusion\/blockage, and the need for possible repeat TT placement after extrusion. Outcomes were quantified using a 0.95 (1 procedure, full recovery) to 0.6 (failed myringoplasty) utility scale. Utility values were discounted over time to incorporate real\u2010life inconvenience.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The intermediate TT accumulated superior total utility in 2\u2010, 4\u2010, and 6\u2010year models (2.48, 3.96, and 5.27 total utility) compared with grommets (2.32, 3.82, 5.18) and T\u2010Tubes (2.42, 3.86, 5.18). Examining a hypothetically otherwise healthy 3000\u2010child cohort, T\u2010Tubes resulted in an increased overall persistent perforation rate (7.9% vs 0.2%, <jats:italic>P<\/jats:italic> &lt;. 001, \u03c7<jats:sup>2<\/jats:sup>). Sensitivity analysis indicated that the rate of repeat TT placement, the utility assigned to having a functional tube in place, and the inconvenience utility discount factor over time were the driving factors of the model.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>The intermediate TT may produce optimal outcomes as it combines a balance of a lower perforation rate than T\u2010Tubes and a longer period of ventilation than grommet tubes.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599814566594","type":"journal-article","created":{"date-parts":[[2015,1,21]],"date-time":"2015-01-21T00:42:19Z","timestamp":1421800939000},"page":"1000-1006","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":11,"title":["How Much Does the Type of Tympanostomy Tube Matter? 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