Acute otitis externa: Consensus definition, diagnostic criteria and core outcome set development.
Journal
PloS one
ISSN: 1932-6203
Titre abrégé: PLoS One
Pays: United States
ID NLM: 101285081
Informations de publication
Date de publication:
2021
2021
Historique:
received:
21
12
2020
accepted:
25
04
2021
entrez:
14
5
2021
pubmed:
15
5
2021
medline:
21
10
2021
Statut:
epublish
Résumé
Evidence for the management of acute otitis externa (AOE) is limited, with unclear diagnostic criteria and variably reported outcome measures that may not reflect key stakeholder priorities. We aimed to develop 1) a definition, 2) diagnostic criteria and 3) a core outcome set (COS) for AOE. COS development according to Core Outcome Measures in Effectiveness Trials (COMET) methodology and parallel consensus selection of diagnostic criteria/definition. Stakeholders from the United Kingdom. Comprehensive literature review identified candidate items for the COS, definition and diagnostic criteria. Nine individuals with past AOE generated further patient-centred candidate items. Candidate items were rated for importance by patient and professional (ENT doctors, general practitioners, microbiologists, nurses, audiologists) stakeholders in a three-round online Delphi exercise. Consensus items were grouped to form the COS, diagnostic criteria, and definition. Candidate COS items from patients (n = 28) and literature (n = 25) were deduplicated and amalgamated to a final candidate list (n = 46). Patients emphasised quality-of-life and the impact on daily activities/work. Via the Delphi process, stakeholders agreed on 31 candidate items. The final COS covered six outcomes: pain; disease severity; impact on quality-of-life and daily activities; patient satisfaction; treatment-related outcome; and microbiology. 14 candidate diagnostic criteria were identified, 8 reaching inclusion consensus. The final definition for AOE was 'diffuse inflammation of the ear canal skin of less than 6 weeks duration'. The development and adoption of a consensus definition, diagnostic criteria and a COS will help to standardise future research in AOE, facilitating meta-analysis. Consulting former patients throughout development highlighted deficiencies in the outcomes adopted previously, in particular concerning the impact of AOE on daily life.
Identifiants
pubmed: 33989313
doi: 10.1371/journal.pone.0251395
pii: PONE-D-20-40118
pmc: PMC8121300
doi:
Types de publication
Journal Article
Langues
eng
Sous-ensembles de citation
IM
Pagination
e0251395Déclaration de conflit d'intérêts
The authors have declared that no competing interests exist.
Références
Otolaryngol Head Neck Surg. 2014 Feb;150(1 Suppl):S1-S24
pubmed: 24491310
Br J Gen Pract. 2001 Jul;51(468):533-8
pubmed: 11462312
Cochrane Database Syst Rev. 2010 Jan 20;(1):CD004740
pubmed: 20091565
J Laryngol Otol. 2018 Apr;132(4):314-317
pubmed: 29429416
BMJ. 2017 May 17;357:j2262
pubmed: 28515234
Syst Rev. 2016 Dec 5;5(1):210
pubmed: 27919275
Trials. 2017 Jun 20;18(Suppl 3):280
pubmed: 28681707