{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,10,21]],"date-time":"2025-10-21T00:28:59Z","timestamp":1761006539589,"version":"build-2065373602"},"reference-count":27,"publisher":"Wiley","issue":"5","license":[{"start":{"date-parts":[[2018,7,31]],"date-time":"2018-07-31T00:00:00Z","timestamp":1532995200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"funder":[{"DOI":"10.13039\/100000002","name":"National Institutes of Health","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100000002","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":[[2018,11]]},"abstract":"<jats:sec><jats:title>Objectives<\/jats:title><jats:p>To determine the association between the introduction of statements 6 and 7\u00a0in the 2013 clinical practice guideline (CPG) for tympanostomy tubes in children and the identification of preoperative middle ear fluid (acute otitis media \/ otitis media with effusion [AOM\/OME]) in children undergoing bilateral myringotomy and tube (BMT) placement.<\/jats:p><\/jats:sec><jats:sec><jats:title>Study Design<\/jats:title><jats:p>Case series with chart review.<\/jats:p><\/jats:sec><jats:sec><jats:title>Setting<\/jats:title><jats:p>Tertiary care children's medical center.<\/jats:p><\/jats:sec><jats:sec><jats:title>Subjects and Methods<\/jats:title><jats:p>Patients who underwent BMT for recurrent AOM were retrospectively reviewed. We examined 240 patients before (BG; 2012) and 240 patients after (AG; 2014) the introduction of the CPG.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>The baseline characteristics of the 2\u00a0groups were comparable. The total annual number of BMT placements performed at our institution decreased from 3957 (BG) to 3083 (AG). There was no significant increase in the rate of preoperative AOM\/OME identification following CPG introduction (BG 78.3% vs AG 83.3%, <jats:italic>P<\/jats:italic> =. 164). The rate of identification of AOM\/OME in the operating room (OR) increased from 54.2% (BG) to 71.3% (AG, <jats:italic>P<\/jats:italic> &lt;. 001). The rate of identification of AOM\/OME both in the clinic and in the OR increased from 55.1% (BG) to 71.3% (AG, <jats:italic>P<\/jats:italic> &lt;. 001). Cases with concordant clinic and OR AOM\/OME occurred among younger children (<jats:italic>P<\/jats:italic> =. 045), those with fewer episodes of AOM (<jats:italic>P<\/jats:italic> =. 043), and those with shorter time between the clinic and OR dates (<jats:italic>P<\/jats:italic> =. 008).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusions<\/jats:title><jats:p>Following the introduction of the CPG, there was no change in the rate of identification of AOM\/OME prior to recommending BMT placement in children with recurrent AOM. The lack of improved compliance with statements 6 and 7\u00a0may be related to multiple clinician\u2010 and patient\u2010derived factors.<\/jats:p><\/jats:sec>","DOI":"10.1177\/0194599818789877","type":"journal-article","created":{"date-parts":[[2018,7,31]],"date-time":"2018-07-31T04:41:51Z","timestamp":1533012111000},"page":"914-919","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":6,"title":["Quality Assessment of the Clinical Practice Guideline for Tympanostomy Tubes in Children"],"prefix":"10.1002","volume":"159","author":[{"given":"Joshua J.","family":"Sturm","sequence":"first","affiliation":[{"name":"Department of Otolaryngology\u2013Head and Neck Surgery Columbia University Medical Center and Weill Cornell Medical College New York New York USA"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Phillip","family":"Huyett","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology University 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