Middle ear disease - Uncertain whether it increases the risk of behaviour problems at 10 years
Clinical Bottom Line
Middle ear disease is associated with a small increase in behaviour problems at 10 years but the difference may not be clinically significant and may be partly explained by socio-economic factors.
Bennett, K.E. Haggard M.P.Behaviour and cognitive outcomes from middle ear disease. Arch Dis Child 1999;80:28-35 .
Are children with middle ear disease at increased risk of behaviour problems?
- Large, national birth cohort of 12,000 children.
- Middle ear disease (discharge or hearing difficulty) and behaviour measured at 5 and 10 years by parental responses to questions and child assessment. Behaviour at 10 years also measured by teacher responses.
- Follow up of about 12, 000 at 5 years and about 9,000 at 10 years. Authors state that loss to follow up did not significantly affect proportions that had middle ear disease.
|Difference in Behaviour Score @ 5 years||0.12
(0.06 to 0.18)
(0.14 to 0.25)
(0.12 to 0.25)
(0.01 to 0.13)
|Difference in Behaviour Score @ 10 years||-0.01
(-0.07 to 0.06)
(0.08 to 0.22)
(0.18 to 0.32)
(0.00 to 0.14)
- The differences in behaviour score are small. However, middle ear disease is common (10% in this cohort) and at a population level, these small differences may be clinically important.
- The slightly higher adverse behaviour scores in children with hearing difficulty could be partly explained by residual confounding due to socio-economic factors.
- Occurence of middle ear disease was based on parental reports and misclassification of exposure was likely. This may reduce the strength of true associations.
R. Gilbert; 4 March 1999