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Centre for Evidence-
Based Medicine

Prognosis: Clinical Scenario

You are a health visitor doing a Child Health Clinic and are approached by the mother of a 2 year old boy who has glue ear, manifest by intermittent ear discharge and hearing difficulty. The mother has seen the ENT surgeon who decided against surgery. She wants to know whether glue ear might cause learning and behavioural problems later in childhood.

What do you tell her?

She asks whether you think she should pay for private grommet surgery. What is your advice? You pose the question, are children with middle ear disease at increased risk of behavioural problems? You recall seeing an article about this in a recent issue of Archives of Disease in Childhood. You review recent issues and find it.

Arch Dis Child 1999;80:28-35

Read the article and decide:

  1. Is this evidence about prognosis valid?
  2. Is this valid evidence about prognosis important?
  3. Can you apply this valid and important evidence about prognosis in caring for your patient?

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