{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,3,18]],"date-time":"2026-03-18T22:00:19Z","timestamp":1773871219907,"version":"3.50.1"},"reference-count":17,"publisher":"Wiley","issue":"6","license":[{"start":{"date-parts":[[2018,2,27]],"date-time":"2018-02-27T00:00:00Z","timestamp":1519689600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/501100000226","name":"Ontario Ministry of Health and Long-Term Care","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000226","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003321","name":"Queen's University","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003321","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2018,6]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Tympanostomy tube (TT) insertion is the most common ambulatory surgery performed on children. American Academy of Otolaryngology\u2014Head and Neck Surgery Founda\u2010tion (AAO\u2010HNSF) Clinical Practice Guidelines (CPGs) recommend hearing testing for all pediatric TT candidates. The aim of this study was to assess audiometric testing in this population.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Retrospective population\u2010based cohort study.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>All hospitals in the Canadian province of Ontario.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>All patients 12 years of age and younger who underwent at least 1 TT procedure between January 1993 and June 2016. The primary outcomes were the percentage of patients who underwent a hearing test within 1 year before and\/or 1 year after surgery.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 316,599 bilateral TT procedures were performed during the study period (1993 to 2016). Presurgical hearing tests increased from 55.7% to 74.9%, and postsurgical hearing tests increased from 42.2% to 68.9%. Younger surgeons demonstrated a greater adherence to the CPGs (relative risk [RR], 1.22; 95% CI, 1.08\u20101.38; <jats:italic>P<\/jats:italic> =. 001). Remarkably, there was not a spike in preoperative hearing tests following the introduction of the CPGs in 2013 (RR, 1.12; 95% CI, 0.85\u20101.47; <jats:italic>P<\/jats:italic> =. 432). Presurgical hearing testing ranged from 26.1% to 83.5% across health regions.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>In this cohort of children who underwent TT placement, the trends of preoperative and postoperative audiometric testing are increasing but are still lower than recommended by the CPGs, despite a tripling of practicing audiologists. This study describes the current state of testing in Ontario and highlights issues of access to audiology services, possible parent preferences, and the importance of ongoing continuing medical education for all health care practitioners.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599818760562","type":"journal-article","created":{"date-parts":[[2018,2,27]],"date-time":"2018-02-27T08:09:58Z","timestamp":1519718998000},"page":"1127-1133","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":9,"title":["Audiometric Testing Guideline Adherence in Children Undergoing Tympanostomy Tubes: A Population\u2010Based Study"],"prefix":"10.1002","volume":"158","author":[{"given":"Jason A.","family":"Beyea","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Hotel Dieu Hospital Kingston Health Sciences Centre Queen's University School of Medicine Kingston ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Emily","family":"Rosen","sequence":"additional","affiliation":[{"name":"Department of Speech Pathology and Audiology Hotel Dieu Hospital Kingston ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Trina","family":"Stephens","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Hotel Dieu Hospital Kingston Health Sciences Centre Queen's University School of Medicine Kingston ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Paul","family":"Nguyen","sequence":"additional","affiliation":[{"name":"Institute for Clinical Evaluative Sciences (ICES) Queen's University Kingston ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Stephen F.","family":"Hall","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Hotel Dieu Hospital Kingston Health Sciences Centre Queen's University School of Medicine Kingston ON Canada"}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"311","published-online":{"date-parts":[[2018,2,27]]},"reference":[{"key":"e_1_2_9_2_1","first-page":"1285","article-title":"Otolaryngologists\u2019 perceptions of the indications for tympanostomy tube insertion in children","volume":"162","author":"McIsaac WJ","year":"2000","journal-title":"CMAJ"},{"key":"e_1_2_9_3_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2016.06.029"},{"key":"e_1_2_9_4_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599813487302"},{"key":"e_1_2_9_5_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599814529080"},{"key":"e_1_2_9_6_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2012.09.029"},{"key":"e_1_2_9_7_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2016.06.004"},{"key":"e_1_2_9_8_1","doi-asserted-by":"publisher","DOI":"10.1177\/0194599817718822"},{"key":"e_1_2_9_9_1","unstructured":"Ministry of Health and Long\u2010Term Care.Ontario schedule of benefits\u2014physician services under the Health Insurance Act.http:\/\/www.health.gov.on.ca\/en\/pro\/programs\/ohip\/sob\/physserv\/sob_master20160401.pdf. Accessed December 20 2017."},{"key":"e_1_2_9_10_1","article-title":"Clinical predictors of multiple tympanostomy tube placements in Ontario children","author":"Beyea JA","year":"2017","journal-title":"Laryngoscope"},{"key":"e_1_2_9_11_1","unstructured":"Ontario Ministry of Finance.Ontario population projections update.https:\/\/www.fin.gov.on.ca\/en\/economy\/demographics\/projections\/projections2016\u20102041.pdf. Accessed December 20 2017."},{"key":"e_1_2_9_12_1","doi-asserted-by":"publisher","DOI":"10.1016\/0196-0709(94)90058-2"},{"key":"e_1_2_9_13_1","doi-asserted-by":"publisher","DOI":"10.7326\/0003-4819-142-4-200502150-00008"},{"key":"e_1_2_9_14_1","doi-asserted-by":"publisher","DOI":"10.1093\/intqhc\/mzx074"},{"key":"e_1_2_9_15_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.jcjo.2014.01.006"},{"key":"e_1_2_9_16_1","doi-asserted-by":"publisher","DOI":"10.9778\/cmajo.20150116"},{"key":"e_1_2_9_17_1","doi-asserted-by":"publisher","DOI":"10.1503\/cmaj.160823"},{"key":"e_1_2_9_18_1","unstructured":"Ontario Wait Times.Ontario wait times for surgeries and procedures.http:\/\/www.ontariowaittimes.com\/SurgeryDI\/EN\/TrendData.aspx?View=1&Type=0&LHIN=0&LHINIDString=10&city=&pc=&dist=0&Modality=0&ModalityString=10&TrendModality=0&ModalityType=125&ModalityTypeString=125&TrendModalityType=125&hosptID=0&HospitalIDString=0&str=&DataType=3&Level=1&IsServiceExits=0&period=0. Accessed December 20 2017."}],"container-title":["Otolaryngology\u2013Head and Neck Surgery"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599818760562","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1177\/0194599818760562","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/pdf\/10.1177\/0194599818760562","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2025,10,20]],"date-time":"2025-10-20T11:05:18Z","timestamp":1760958318000},"score":1,"resource":{"primary":{"URL":"https:\/\/aao-hnsfjournals.onlinelibrary.wiley.com\/doi\/10.1177\/0194599818760562"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2018,2,27]]},"references-count":17,"journal-issue":{"issue":"6","published-print":{"date-parts":[[2018,6]]}},"alternative-id":["10.1177\/0194599818760562"],"URL":"https:\/\/doi.org\/10.1177\/0194599818760562","archive":["Portico"],"relation":{},"ISSN":["0194-5998","1097-6817"],"issn-type":[{"value":"0194-5998","type":"print"},{"value":"1097-6817","type":"electronic"}],"subject":[],"published":{"date-parts":[[2018,2,27]]},"assertion":[{"value":"2017-11-01","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-01-31","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2018-02-27","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}