Sensitivity, specificity and predictive value of tympanometry in predicting a hearing impairment in otitis media with effusion

M. P. Haggard; K. E. Bennett; J. A. Birkin; G. G. Browning; M. M. Gannon; J. M. Higson; S. E. Hind; S. C. Smith; E. E. Egner; T. Hayman; T. R.A. Carroll; H. Jones; T. B. Richmond; A. R. Wade; J. L. Baskill; D. C. Greenwood; D. A. Adams; J. G. Toner; K. Pearman; D. A. Proops; M. V. Griffiths; R. G. Williams; A. R. Curry; A. I.G. Kerr; P. Robb; N. K. Geddes; C. Morrisey; G. E. Murty; A. A. Narula; R. S.A. Thomas; D. J. Willat; A. P. Zarod; J. A. Wilson; D. Meikle; I. Johnson; J. P. Birchall; K. P. Gibbin; N. S. Jones; D. R. Robinson; P. D. Bull; D. F. Chapman; A. Parker; I. MacKee; K. Law; R. Flanagan; G. Housten; G. Fitzjohn; M. Bingham; J. Cassidy; C. Burns; C. Hamill; L. Glover; L. Eccles; G. Armstrong-Bednall; B. Towle; K. Reeves; J. Carr; J. Marshall; A. Levick; P. Dunmore; C. Parker-Emery; R. Sutton; L. Midgley; N. Barnett; R. Foley; M. Hodges; C. Lawrence; A. Walsh; T. Loxley; M. White; R. Barr-Hamilton; S. Wilson; R. Edgar; C. Elliot; T. Davidson; L. Walker; J. McCourt; W. Plaister; D. Walker; R. Najaran; H. Thomas; B. Paul; M. Gilbert; S. Walker; E. Griffiths; C. Treaty; A. Carmichael; R. Ronson; K. France; H. Pilkington; F. Hilton; E. Brown; P. James; J. Kingscott; G. Whitby; R. Allen; M. Casey; A. Mergarry; G. Hughes

doi:10.1046/j.1365-2273.1999.00259.x

Sensitivity, specificity and predictive value of tympanometry in predicting a hearing impairment in otitis media with effusion

M. P. Haggard, K. E. Bennett, J. A. Birkin, G. G. Browning^*, M. M. Gannon, J. M. Higson, S. E. Hind, S. C. Smith, E. E. Egner, T. Hayman, T. R.A. Carroll, H. Jones, T. B. Richmond, A. R. Wade, J. L. Baskill, D. C. Greenwood, D. A. Adams, J. G. Toner, K. Pearman, D. A. ProopsM. V. Griffiths, R. G. Williams, A. R. Curry, A. I.G. Kerr, P. Robb, N. K. Geddes, C. Morrisey, G. E. Murty, A. A. Narula, R. S.A. Thomas, D. J. Willat, A. P. Zarod, J. A. Wilson, D. Meikle, I. Johnson, J. P. Birchall, K. P. Gibbin, N. S. Jones, D. R. Robinson, P. D. Bull, D. F. Chapman, A. Parker, I. MacKee, K. Law, R. Flanagan, G. Housten, G. Fitzjohn, M. Bingham, J. Cassidy, C. Burns, C. Hamill, L. Glover, L. Eccles, G. Armstrong-Bednall, B. Towle, K. Reeves, J. Carr, J. Marshall, A. Levick, P. Dunmore, C. Parker-Emery, R. Sutton, L. Midgley, N. Barnett, R. Foley, M. Hodges, C. Lawrence, A. Walsh, T. Loxley, M. White, R. Barr-Hamilton, S. Wilson, R. Edgar, C. Elliot, T. Davidson, L. Walker, J. McCourt, W. Plaister, D. Walker, R. Najaran, H. Thomas, B. Paul, M. Gilbert, S. Walker, E. Griffiths, C. Treaty, A. Carmichael, R. Ronson, K. France, H. Pilkington, F. Hilton, E. Brown, P. James, J. Kingscott, G. Whitby, R. Allen, M. Casey, A. Mergarry, G. Hughes

^*Corresponding author for this work

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

25 Citations (Scopus)

Abstract

Children with otitis media with effusion (OME) need monitoring over time to identify persistence of disease and to assess their hearing thresholds as a surrogate of auditory disability. It would be useful if tympanometry could be used to predict those with an impairment. This study looked at 1153 children, aged between 3.25 and 6.75 years, referred for suspected OME. The inclusion of type C₂ tympanograms with type B tympanograms versus all other tympanogram types increased the sensitivity of detecting air-conduction thresholds and air-bone gaps of various magnitudes in the better hearing ear but lowered the specificity and the positive predictive value. Extending the pressure range to -600 daPa and excluding the 30% of children with poor concentration on audiometry made no difference to the sensitivity and specificity. The results were the same for the poorer hearing ear. These findings are of practical help in monitoring children with OME. Thus taking an air-conduction average of 25 dB HL in the better ear as the level needing detection, if all children are audiometrically assessed then 100% of those with an impairment will be identified. Limiting audiometry to those with a bilateral type B tympanogram reduces the workload by 50%, but 90% of impaired children will still be detected. Limiting audiometry to those with type B or C₂ tympanograms reduces the workload to 69% of the sample, and 95% of impaired children will be identified. With such data, decisions as to how to allocate limited audiometric resources for monitoring children with OME are made easier.

Original language	English
Pages (from-to)	294-300
Number of pages	7
Journal	Clinical Otolaryngology and Allied Sciences
Volume	24
Issue number	4
DOIs	https://doi.org/10.1046/j.1365-2273.1999.00259.x
Publication status	Published - 1999
Externally published	Yes

Keywords

Acoustic impedance tests
Audiometry
Hearing disorders
Otitis media with effusion
Sensitivity and specificity
Tympanometry

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10.1046/j.1365-2273.1999.00259.x

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Haggard, M. P., Bennett, K. E., Birkin, J. A., Browning, G. G., Gannon, M. M., Higson, J. M., Hind, S. E., Smith, S. C., Egner, E. E., Hayman, T., Carroll, T. R. A., Jones, H., Richmond, T. B., Wade, A. R., Baskill, J. L., Greenwood, D. C., Adams, D. A., Toner, J. G., Pearman, K., ... Hughes, G. (1999). Sensitivity, specificity and predictive value of tympanometry in predicting a hearing impairment in otitis media with effusion. Clinical Otolaryngology and Allied Sciences, 24(4), 294-300. https://doi.org/10.1046/j.1365-2273.1999.00259.x

@article{16e671f323cc428c97dd532be079219d,

title = "Sensitivity, specificity and predictive value of tympanometry in predicting a hearing impairment in otitis media with effusion",

abstract = "Children with otitis media with effusion (OME) need monitoring over time to identify persistence of disease and to assess their hearing thresholds as a surrogate of auditory disability. It would be useful if tympanometry could be used to predict those with an impairment. This study looked at 1153 children, aged between 3.25 and 6.75 years, referred for suspected OME. The inclusion of type C2 tympanograms with type B tympanograms versus all other tympanogram types increased the sensitivity of detecting air-conduction thresholds and air-bone gaps of various magnitudes in the better hearing ear but lowered the specificity and the positive predictive value. Extending the pressure range to -600 daPa and excluding the 30% of children with poor concentration on audiometry made no difference to the sensitivity and specificity. The results were the same for the poorer hearing ear. These findings are of practical help in monitoring children with OME. Thus taking an air-conduction average of 25 dB HL in the better ear as the level needing detection, if all children are audiometrically assessed then 100% of those with an impairment will be identified. Limiting audiometry to those with a bilateral type B tympanogram reduces the workload by 50%, but 90% of impaired children will still be detected. Limiting audiometry to those with type B or C2 tympanograms reduces the workload to 69% of the sample, and 95% of impaired children will be identified. With such data, decisions as to how to allocate limited audiometric resources for monitoring children with OME are made easier.",

keywords = "Acoustic impedance tests, Audiometry, Hearing disorders, Otitis media with effusion, Sensitivity and specificity, Tympanometry",

author = "Haggard, {M. P.} and Bennett, {K. E.} and Birkin, {J. A.} and Browning, {G. G.} and Gannon, {M. M.} and Higson, {J. M.} and Hind, {S. E.} and Smith, {S. C.} and Egner, {E. E.} and T. Hayman and Carroll, {T. R.A.} and H. Jones and Richmond, {T. B.} and Wade, {A. R.} and Baskill, {J. L.} and Greenwood, {D. C.} and Adams, {D. A.} and Toner, {J. G.} and K. Pearman and Proops, {D. A.} and Griffiths, {M. V.} and Williams, {R. G.} and Curry, {A. R.} and Kerr, {A. I.G.} and P. Robb and Geddes, {N. K.} and C. Morrisey and Murty, {G. E.} and Narula, {A. A.} and Thomas, {R. S.A.} and Willat, {D. J.} and Zarod, {A. P.} and Wilson, {J. A.} and D. Meikle and I. Johnson and Birchall, {J. P.} and Gibbin, {K. P.} and Jones, {N. S.} and Robinson, {D. R.} and Bull, {P. D.} and Chapman, {D. F.} and A. Parker and I. MacKee and K. Law and R. Flanagan and G. Housten and G. Fitzjohn and M. Bingham and J. Cassidy and C. Burns and C. Hamill and L. Glover and L. Eccles and G. Armstrong-Bednall and B. Towle and K. Reeves and J. Carr and J. Marshall and A. Levick and P. Dunmore and C. Parker-Emery and R. Sutton and L. Midgley and N. Barnett and R. Foley and M. Hodges and C. Lawrence and A. Walsh and T. Loxley and M. White and R. Barr-Hamilton and S. Wilson and R. Edgar and C. Elliot and T. Davidson and L. Walker and J. McCourt and W. Plaister and D. Walker and R. Najaran and H. Thomas and B. Paul and M. Gilbert and S. Walker and E. Griffiths and C. Treaty and A. Carmichael and R. Ronson and K. France and H. Pilkington and F. Hilton and E. Brown and P. James and J. Kingscott and G. Whitby and R. Allen and M. Casey and A. Mergarry and G. Hughes",

year = "1999",

doi = "10.1046/j.1365-2273.1999.00259.x",

language = "English",

volume = "24",

pages = "294--300",

journal = "Clinical Otolaryngology and Allied Sciences",

issn = "0307-7772",

publisher = "Wiley-Blackwell Publishing Ltd",

number = "4",

}

Haggard, MP, Bennett, KE, Birkin, JA, Browning, GG, Gannon, MM, Higson, JM, Hind, SE, Smith, SC, Egner, EE, Hayman, T, Carroll, TRA, Jones, H, Richmond, TB, Wade, AR, Baskill, JL, Greenwood, DC, Adams, DA, Toner, JG, Pearman, K, Proops, DA, Griffiths, MV, Williams, RG, Curry, AR, Kerr, AIG, Robb, P, Geddes, NK, Morrisey, C, Murty, GE, Narula, AA, Thomas, RSA, Willat, DJ, Zarod, AP, Wilson, JA, Meikle, D, Johnson, I, Birchall, JP, Gibbin, KP, Jones, NS, Robinson, DR, Bull, PD, Chapman, DF, Parker, A, MacKee, I, Law, K, Flanagan, R, Housten, G, Fitzjohn, G, Bingham, M, Cassidy, J, Burns, C, Hamill, C, Glover, L, Eccles, L, Armstrong-Bednall, G, Towle, B, Reeves, K, Carr, J, Marshall, J, Levick, A, Dunmore, P, Parker-Emery, C, Sutton, R, Midgley, L, Barnett, N, Foley, R, Hodges, M, Lawrence, C, Walsh, A, Loxley, T, White, M, Barr-Hamilton, R, Wilson, S, Edgar, R, Elliot, C, Davidson, T, Walker, L, McCourt, J, Plaister, W, Walker, D, Najaran, R, Thomas, H, Paul, B, Gilbert, M, Walker, S, Griffiths, E, Treaty, C, Carmichael, A, Ronson, R, France, K, Pilkington, H, Hilton, F, Brown, E, James, P, Kingscott, J, Whitby, G, Allen, R, Casey, M, Mergarry, A & Hughes, G 1999, 'Sensitivity, specificity and predictive value of tympanometry in predicting a hearing impairment in otitis media with effusion', Clinical Otolaryngology and Allied Sciences, vol. 24, no. 4, pp. 294-300. https://doi.org/10.1046/j.1365-2273.1999.00259.x

TY - JOUR

T1 - Sensitivity, specificity and predictive value of tympanometry in predicting a hearing impairment in otitis media with effusion

AU - Haggard, M. P.

AU - Bennett, K. E.

AU - Birkin, J. A.

AU - Browning, G. G.

AU - Gannon, M. M.

AU - Higson, J. M.

AU - Hind, S. E.

AU - Smith, S. C.

AU - Egner, E. E.

AU - Hayman, T.

AU - Carroll, T. R.A.

AU - Jones, H.

AU - Richmond, T. B.

AU - Wade, A. R.

AU - Baskill, J. L.

AU - Greenwood, D. C.

AU - Adams, D. A.

AU - Toner, J. G.

AU - Pearman, K.

AU - Proops, D. A.

AU - Griffiths, M. V.

AU - Williams, R. G.

AU - Curry, A. R.

AU - Kerr, A. I.G.

AU - Robb, P.

AU - Geddes, N. K.

AU - Morrisey, C.

AU - Murty, G. E.

AU - Narula, A. A.

AU - Thomas, R. S.A.

AU - Willat, D. J.

AU - Zarod, A. P.

AU - Wilson, J. A.

AU - Meikle, D.

AU - Johnson, I.

AU - Birchall, J. P.

AU - Gibbin, K. P.

AU - Jones, N. S.

AU - Robinson, D. R.

AU - Bull, P. D.

AU - Chapman, D. F.

AU - Parker, A.

AU - MacKee, I.

AU - Law, K.

AU - Flanagan, R.

AU - Housten, G.

AU - Fitzjohn, G.

AU - Bingham, M.

AU - Cassidy, J.

AU - Burns, C.

AU - Hamill, C.

AU - Glover, L.

AU - Eccles, L.

AU - Armstrong-Bednall, G.

AU - Towle, B.

AU - Reeves, K.

AU - Carr, J.

AU - Marshall, J.

AU - Levick, A.

AU - Dunmore, P.

AU - Parker-Emery, C.

AU - Sutton, R.

AU - Midgley, L.

AU - Barnett, N.

AU - Foley, R.

AU - Hodges, M.

AU - Lawrence, C.

AU - Walsh, A.

AU - Loxley, T.

AU - White, M.

AU - Barr-Hamilton, R.

AU - Wilson, S.

AU - Edgar, R.

AU - Elliot, C.

AU - Davidson, T.

AU - Walker, L.

AU - McCourt, J.

AU - Plaister, W.

AU - Walker, D.

AU - Najaran, R.

AU - Thomas, H.

AU - Paul, B.

AU - Gilbert, M.

AU - Walker, S.

AU - Griffiths, E.

AU - Treaty, C.

AU - Carmichael, A.

AU - Ronson, R.

AU - France, K.

AU - Pilkington, H.

AU - Hilton, F.

AU - Brown, E.

AU - James, P.

AU - Kingscott, J.

AU - Whitby, G.

AU - Allen, R.

AU - Casey, M.

AU - Mergarry, A.

AU - Hughes, G.

PY - 1999

Y1 - 1999

N2 - Children with otitis media with effusion (OME) need monitoring over time to identify persistence of disease and to assess their hearing thresholds as a surrogate of auditory disability. It would be useful if tympanometry could be used to predict those with an impairment. This study looked at 1153 children, aged between 3.25 and 6.75 years, referred for suspected OME. The inclusion of type C2 tympanograms with type B tympanograms versus all other tympanogram types increased the sensitivity of detecting air-conduction thresholds and air-bone gaps of various magnitudes in the better hearing ear but lowered the specificity and the positive predictive value. Extending the pressure range to -600 daPa and excluding the 30% of children with poor concentration on audiometry made no difference to the sensitivity and specificity. The results were the same for the poorer hearing ear. These findings are of practical help in monitoring children with OME. Thus taking an air-conduction average of 25 dB HL in the better ear as the level needing detection, if all children are audiometrically assessed then 100% of those with an impairment will be identified. Limiting audiometry to those with a bilateral type B tympanogram reduces the workload by 50%, but 90% of impaired children will still be detected. Limiting audiometry to those with type B or C2 tympanograms reduces the workload to 69% of the sample, and 95% of impaired children will be identified. With such data, decisions as to how to allocate limited audiometric resources for monitoring children with OME are made easier.

AB - Children with otitis media with effusion (OME) need monitoring over time to identify persistence of disease and to assess their hearing thresholds as a surrogate of auditory disability. It would be useful if tympanometry could be used to predict those with an impairment. This study looked at 1153 children, aged between 3.25 and 6.75 years, referred for suspected OME. The inclusion of type C2 tympanograms with type B tympanograms versus all other tympanogram types increased the sensitivity of detecting air-conduction thresholds and air-bone gaps of various magnitudes in the better hearing ear but lowered the specificity and the positive predictive value. Extending the pressure range to -600 daPa and excluding the 30% of children with poor concentration on audiometry made no difference to the sensitivity and specificity. The results were the same for the poorer hearing ear. These findings are of practical help in monitoring children with OME. Thus taking an air-conduction average of 25 dB HL in the better ear as the level needing detection, if all children are audiometrically assessed then 100% of those with an impairment will be identified. Limiting audiometry to those with a bilateral type B tympanogram reduces the workload by 50%, but 90% of impaired children will still be detected. Limiting audiometry to those with type B or C2 tympanograms reduces the workload to 69% of the sample, and 95% of impaired children will be identified. With such data, decisions as to how to allocate limited audiometric resources for monitoring children with OME are made easier.

KW - Acoustic impedance tests

KW - Audiometry

KW - Hearing disorders

KW - Otitis media with effusion

KW - Sensitivity and specificity

KW - Tympanometry

UR - http://www.scopus.com/inward/record.url?scp=0032804724&partnerID=8YFLogxK

U2 - 10.1046/j.1365-2273.1999.00259.x

DO - 10.1046/j.1365-2273.1999.00259.x

M3 - Article

C2 - 10472463

AN - SCOPUS:0032804724

SN - 0307-7772

VL - 24

SP - 294

EP - 300

JO - Clinical Otolaryngology and Allied Sciences

JF - Clinical Otolaryngology and Allied Sciences

IS - 4

ER -

Sensitivity, specificity and predictive value of tympanometry in predicting a hearing impairment in otitis media with effusion

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