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. 2024 Jan-Dec:53:19160216241248538.
doi: 10.1177/19160216241248538.

Proposed Quality Indicators for Aspects of Pediatric Acute Otitis Media Management

Justin Cottrell  1 , Amirpouyan Namavarian  2 , Jonathan Yip  2 , Paolo Campisi  2 , Neil K Chadha  3 , Ali Damji  4 , Paul Hong  5 , Sophie Lachance  6 , Darren Leitao  7 , Lily H P Nguyen  8 , Natasha Saunders  9 , Julie Strychowsky  10 , Warren Yunker  11 , Jean-Philippe Vaccani  12 , Yvonne Chan  2 , John R de Almeida  2 , Antoine Eskander  2 , Ian J Witterick  2 , Eric Monteiro  2
Affiliations

Proposed Quality Indicators for Aspects of Pediatric Acute Otitis Media Management

Justin Cottrell et al. J Otolaryngol Head Neck Surg. 2024 Jan-Dec.

Abstract

Background: The high incidence of pediatric acute otitis media (AOM) makes the implications of overdiagnosis and overtreatment far-reaching. Quality indicators (QIs) for AOM are limited, drawing from generalized upper respiratory infection QIs, or locally developed benchmarks. Recognizing this, we sought to develop pediatric AOM QIs to build a foundation for future quality improvement efforts.

Methods: Candidate indicators (CIs) were extracted from existing guidelines and position statements. The modified RAND Corporation/University of California, Los Angeles (RAND/UCLA) appropriateness methodology was used to select the final QIs by an 11-member expert panel consisting of otolaryngology-head and neck surgeons, a pediatrician and family physician.

Results: Twenty-seven CIs were identified after literature review, with an additional CI developed by the expert panel. After the first round of evaluations, the panel agreed on 4 CIs as appropriate QIs. After an expert panel meeting and subsequent second round of evaluations, the panel agreed on 8 final QIs as appropriate measures of high-quality care. The 8 final QIs focus on topics of antimicrobial management, specialty referral, and tympanostomy tube counseling.

Conclusions: Evidence of variable and substandard care persists in the diagnosis and management of pediatric AOM despite the existence of high-quality guidelines. This study proposes 8 QIs which compliment guideline recommendations and are meant to facilitate future quality improvement initiatives that can improve patient outcomes.

Keywords: acute otitis media; infectious diseases; otitis media; quality; quality improvement; quality indicators.

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Conflict of interest statement

Declaration of Conflicting InterestsThe author declared no potential conflicts of interest with respect to the research, authorship, and/or publication of this article.

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