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Centre for Evidence-
Based Medicine

Diagnosis: Clinical Scenario

A father brought in his 2 year old boy because of a "cold" and also concern about his hearing and speech development. He thought the boy sometimes heard well and other days appeared deaf. Clinical examination showed dull tympanic membranes with retraction on the left. I wondered how accurate the clinics microtympanometer was for the diagnosis of otitis media with effusion and eustrachian tube dysfunction and formulated the question, what is the accuracy of microtympanometry for the diagnosis of hearing loss from a middle ear effusion in young children?

Searching terms and evidence source: (tympanomet* OR impedance) AND (otitis media OR middle ear) AND audiomet* (MEDLINE)

Read the article and decide:

  1. Is the evidence from this article valid?
  2. If valid, is this evidence important?
  3. If valid and important, can you apply this evidence in caring for your patient?

Continue to completed worksheet