Effect of accurate diagnostic criteria on incidence of acute otitis media in otitis-prone children.

Over 70% of children currently suffer from acute otitis media (AOM) before their second birthday, and incidence is increasing rapidly. Recent studies have raised concern about inadequate use of diagnostic equipment and insufficient training in diagnoses. We recruited 309 children with a history of recurrent otitis media who were followed for 6 months during 1 infectious season. A study physician examined and treated any child whose parents suspected AOM. Pneumatic otoscope and tympanometry were used. Number of AOM diagnoses during the study was compared with AOM diagnoses during the preceding 6-month period. AOM diagnoses decreased 56%, and nearly 80% of children had fewer episodes of AOM discovered than during the preceding 6 months. AOM is frequently over-diagnosed. Use of proper diagnostic criteria, the pneumatic otoscope, and tympanometry can help correct diagnosis, and thereby reduce incidence of AOM.