Overuse of tympanostomy tubes in New York metropolitan area: evidence from five hospital cohort
2008

Overuse of Tympanostomy Tubes in New York

Sample size: 682 publication Evidence: high

Author Information

Author(s): Salomeh Keyhani, Lawrence C Kleinman, Michael Rothschild, Joseph M Bernstein, Rebecca Anderson, Mark Chassin

Primary Institution: Mount Sinai School of Medicine

Hypothesis

Are tympanostomy tube insertions for children with otitis media in 2002 consistent with expert guidelines?

Conclusion

Most tympanostomy tube insertions in New York were inappropriate according to expert criteria and guidelines.

Supporting Evidence

  • 30.3% of tympanostomy procedures were concordant with explicit criteria.
  • 7.5% of procedures were concordant with the 1994 guideline.
  • 69% of cases were classified as inappropriate according to the study's criteria.

Takeaway

Doctors are putting tubes in kids' ears too often, even when it's not needed, which isn't good for their health.

Methodology

Retrospective cohort study analyzing medical records of children who received tympanostomy tubes.

Potential Biases

Potential bias due to reliance on medical records which may not fully capture the clinical context.

Limitations

Data collection was limited to children with complete records, and some charts were inaccessible due to privacy rules.

Participant Demographics

Mean age 3.8 years, 61% white, 74% had private insurance.

Digital Object Identifier (DOI)

10.1136/bmj.a1607

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