Otitis media guidelines for Australian Aboriginal and Torres Strait Islander children: Summary of recommendations

Amanda J. Leach; Peter S. Morris; Harvey L.C. Coates; Sandra Nelson; Stephen J. O'Leary; Peter C. Richmond; Hasantha Gunasekera; Samantha Harkus; Kelvin Kong; Christopher G. Brennan-Jones; Sam Brophy-Williams; Kathy Currie; Sumon K. Das; David Isaacs; Katherine Jarosz; Deborah Lehmann; Jarod Pak; Hemi Patel; Chris Perry; Jennifer S. Reath; Jessica Sommer; Paul J. Torzillo

doi:10.5694/mja2.50953

Otitis media guidelines for Australian Aboriginal and Torres Strait Islander children: Summary of recommendations

Amanda J. Leach, Peter S. Morris, Harvey L.C. Coates, Sandra Nelson, Stephen J. O'Leary, Peter C. Richmond, Hasantha Gunasekera, Samantha Harkus, Kelvin Kong, Christopher G. Brennan-Jones, Sam Brophy-Williams, Kathy Currie, Sumon K. Das, David Isaacs, Katherine Jarosz, Deborah Lehmann, Jarod Pak, Hemi Patel, Chris Perry, Jennifer S. ReathJessica Sommer, Paul J. Torzillo

Menzies School of Health Research

Research output: Contribution to journal › Article › peer-review

33 Citations (Scopus)

98 Downloads (Pure)

Abstract

Introduction:

The 2001 Recommendations for clinical care guidelines on the management of otitis media in Aboriginal and Torres Islander populations were revised in 2010. This 2020 update by the Centre of Research Excellence in Ear and Hearing Health of Aboriginal and Torres Strait Islander Children used for the first time the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach.

Main recommendations:

We performed systematic reviews of evidence across prevention, diagnosis, prognosis and management. We report ten algorithms to guide diagnosis and clinical management of all forms of otitis media. The guidelines include 14 prevention and 37 treatment strategies addressing 191 questions.

Changes in management as a result of the guidelines:

•A GRADE approach is used.

•Targeted recommendations for both high and low risk children.

•New tympanostomy tube otorrhoea section. New Priority 5 for health services: annual and catch-up ear health checks for at-risk children.

Antibiotics are strongly recommended for persistent otitis media with effusion in high risk children.

•Azithromycin is strongly recommended for acute otitis media where adherence is difficult or there is no access to refrigeration. Concurrent audiology and surgical referrals are recommended where delays are likely.

•Surgical referral is recommended for chronic suppurative otitis media at the time of diagnosis.

•The use of autoinflation devices is recommended for some children with persistent otitis media with effusion.

•Definitions for mild (21–30 dB) and moderate (> 30 dB) hearing impairment have been updated.

•New “OMapp” enables free fast access to the guidelines, plus images, animations, and multiple Aboriginal and Torres Strait Islander language audio translations to aid communication with families.

Original language	English
Article number	mja20.00302
Pages (from-to)	228-233
Number of pages	6
Journal	The Medical journal of Australia
Volume	214
Issue number	5
DOIs	https://doi.org/10.5694/mja2.50953
Publication status	Published - Mar 2021

Bibliographical note

Funding Information:
The otitis media guideline update and OMapp development were funded by the National Health and Medical Research Council Centre of Research Excellence in Ear and Hearing Health of Aboriginal and Torres Strait Children (GNT1078557) and GlaxoSmithKline outreach project (Grant No. 2016‐093–4235983). These funding sources had no role in the planning, writing or publication of the work. The 2020 OM guidelines update is dedicated to the late Judith Boswell, who died on 4 April 2017.

Publisher Copyright:
© 2021 Commonwealth of Australia and The Menzies School of Health Research. Medical Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of AMPCo Pty Ltd

Copyright:
Copyright 2021 Elsevier B.V., All rights reserved.

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Leach, A. J., Morris, P. S., Coates, H. L. C., Nelson, S., O'Leary, S. J., Richmond, P. C., Gunasekera, H., Harkus, S., Kong, K., Brennan-Jones, C. G., Brophy-Williams, S., Currie, K., Das, S. K., Isaacs, D., Jarosz, K., Lehmann, D., Pak, J., Patel, H., Perry, C., ... Torzillo, P. J. (2021). Otitis media guidelines for Australian Aboriginal and Torres Strait Islander children: Summary of recommendations. The Medical journal of Australia, 214(5), 228-233. Article mja20.00302. https://doi.org/10.5694/mja2.50953

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abstract = "Introduction: The 2001 Recommendations for clinical care guidelines on the management of otitis media in Aboriginal and Torres Islander populations were revised in 2010. This 2020 update by the Centre of Research Excellence in Ear and Hearing Health of Aboriginal and Torres Strait Islander Children used for the first time the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Main recommendations: We performed systematic reviews of evidence across prevention, diagnosis, prognosis and management. We report ten algorithms to guide diagnosis and clinical management of all forms of otitis media. The guidelines include 14 prevention and 37 treatment strategies addressing 191 questions. Changes in management as a result of the guidelines: •A GRADE approach is used. •Targeted recommendations for both high and low risk children. •New tympanostomy tube otorrhoea section. New Priority 5 for health services: annual and catch-up ear health checks for at-risk children. Antibiotics are strongly recommended for persistent otitis media with effusion in high risk children. •Azithromycin is strongly recommended for acute otitis media where adherence is difficult or there is no access to refrigeration. Concurrent audiology and surgical referrals are recommended where delays are likely. •Surgical referral is recommended for chronic suppurative otitis media at the time of diagnosis. •The use of autoinflation devices is recommended for some children with persistent otitis media with effusion. •Definitions for mild (21–30 dB) and moderate (> 30 dB) hearing impairment have been updated. •New “OMapp” enables free fast access to the guidelines, plus images, animations, and multiple Aboriginal and Torres Strait Islander language audio translations to aid communication with families.",

keywords = "Child health, Ear diseases, Evidence-based medicine, Guidelines as topic, Hearing disorders, Indigenous health",

author = "Leach, {Amanda J.} and Morris, {Peter S.} and Coates, {Harvey L.C.} and Sandra Nelson and O'Leary, {Stephen J.} and Richmond, {Peter C.} and Hasantha Gunasekera and Samantha Harkus and Kelvin Kong and Brennan-Jones, {Christopher G.} and Sam Brophy-Williams and Kathy Currie and Das, {Sumon K.} and David Isaacs and Katherine Jarosz and Deborah Lehmann and Jarod Pak and Hemi Patel and Chris Perry and Reath, {Jennifer S.} and Jessica Sommer and Torzillo, {Paul J.}",

note = "Funding Information: The otitis media guideline update and OMapp development were funded by the National Health and Medical Research Council Centre of Research Excellence in Ear and Hearing Health of Aboriginal and Torres Strait Children (GNT1078557) and GlaxoSmithKline outreach project (Grant No. 2016‐093–4235983). These funding sources had no role in the planning, writing or publication of the work. The 2020 OM guidelines update is dedicated to the late Judith Boswell, who died on 4 April 2017. Publisher Copyright: {\textcopyright} 2021 Commonwealth of Australia and The Menzies School of Health Research. Medical Journal of Australia published by John Wiley & Sons Australia, Ltd on behalf of AMPCo Pty Ltd Copyright: Copyright 2021 Elsevier B.V., All rights reserved.",

year = "2021",

month = mar,

doi = "10.5694/mja2.50953",

language = "English",

volume = "214",

pages = "228--233",

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Leach, AJ , Morris, PS, Coates, HLC, Nelson, S, O'Leary, SJ, Richmond, PC, Gunasekera, H, Harkus, S, Kong, K, Brennan-Jones, CG, Brophy-Williams, S, Currie, K, Das, SK, Isaacs, D, Jarosz, K, Lehmann, D, Pak, J, Patel, H, Perry, C, Reath, JS, Sommer, J & Torzillo, PJ 2021, 'Otitis media guidelines for Australian Aboriginal and Torres Strait Islander children: Summary of recommendations', The Medical journal of Australia, vol. 214, no. 5, mja20.00302, pp. 228-233. https://doi.org/10.5694/mja2.50953

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T1 - Otitis media guidelines for Australian Aboriginal and Torres Strait Islander children

T2 - Summary of recommendations

AU - Leach, Amanda J.

AU - Morris, Peter S.

AU - Coates, Harvey L.C.

AU - Nelson, Sandra

AU - O'Leary, Stephen J.

AU - Richmond, Peter C.

AU - Gunasekera, Hasantha

AU - Harkus, Samantha

AU - Kong, Kelvin

AU - Brennan-Jones, Christopher G.

AU - Brophy-Williams, Sam

AU - Currie, Kathy

AU - Das, Sumon K.

AU - Isaacs, David

AU - Jarosz, Katherine

AU - Lehmann, Deborah

AU - Pak, Jarod

AU - Patel, Hemi

AU - Perry, Chris

AU - Reath, Jennifer S.

AU - Sommer, Jessica

AU - Torzillo, Paul J.

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PY - 2021/3

Y1 - 2021/3

N2 - Introduction: The 2001 Recommendations for clinical care guidelines on the management of otitis media in Aboriginal and Torres Islander populations were revised in 2010. This 2020 update by the Centre of Research Excellence in Ear and Hearing Health of Aboriginal and Torres Strait Islander Children used for the first time the Grading of Recommendations, Assessment, Development and Evaluation (GRADE) approach. Main recommendations: We performed systematic reviews of evidence across prevention, diagnosis, prognosis and management. We report ten algorithms to guide diagnosis and clinical management of all forms of otitis media. The guidelines include 14 prevention and 37 treatment strategies addressing 191 questions. Changes in management as a result of the guidelines: •A GRADE approach is used. •Targeted recommendations for both high and low risk children. •New tympanostomy tube otorrhoea section. New Priority 5 for health services: annual and catch-up ear health checks for at-risk children. Antibiotics are strongly recommended for persistent otitis media with effusion in high risk children. •Azithromycin is strongly recommended for acute otitis media where adherence is difficult or there is no access to refrigeration. Concurrent audiology and surgical referrals are recommended where delays are likely. •Surgical referral is recommended for chronic suppurative otitis media at the time of diagnosis. •The use of autoinflation devices is recommended for some children with persistent otitis media with effusion. •Definitions for mild (21–30 dB) and moderate (> 30 dB) hearing impairment have been updated. •New “OMapp” enables free fast access to the guidelines, plus images, animations, and multiple Aboriginal and Torres Strait Islander language audio translations to aid communication with families.

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KW - Ear diseases

KW - Evidence-based medicine

KW - Guidelines as topic

KW - Hearing disorders

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ER -

Otitis media guidelines for Australian Aboriginal and Torres Strait Islander children: Summary of recommendations

Abstract

Bibliographical note

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