Should children be screened to undergo early treatment for otitis media with effusion? A systematic review of randomized trials

Christopher Butler, H L MacMillan, J C van der Wouden

Research output: Contribution to journalReview articleAcademicpeer-review


BACKGROUND: Otitis media with effusion (OME) is the most common cause of acquired hearing loss in childhood and has been associated with delayed language development and behavioural problems. Some have argued that children should be screened and treated early if found to have clinically important OME. The aim of this review was to assess evidence from randomized controlled trials about the effectiveness of screening and treating children with clinically important OME in the first 4 years of their life. The primary outcome was language development.

METHODS: We searched the Cochrane Controlled Trials Register, MEDLINE and EMBASE and reference lists of all included studies in February 2003. We also contacted the first authors of the studies included in this review. Search terms included otitis media; otitis media with effusion; glue ear; OME; screen; children; treatment; language; and behaviour. Data extraction and methodological quality assessment were performed by at least two of us for each study independently, using methods described in the Cochrane Collaboration Handbook.

RESULTS: From the three included randomized controlled trials evaluating interventions among children with OME identified through screening, we found no evidence of clinically important benefit in language development.

CONCLUSIONS: The identified randomized trials do not show an important benefit on language development from screening the general population of asymptomatic children in the first 4 years of life to undergo early treatment for OME. Screening asymptomatic children in the first 4 years of life for OME is not recommended.

Original languageEnglish
Pages (from-to)425-32
Number of pages8
JournalChild: Care, Health and Development
Issue number6
Publication statusPublished - Nov 2003
Externally publishedYes

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