Disclaimer
is Guideline attempts to define principles of practice that should produce high-quality patient care. It
is applicable to specialists, primary care practitioners, and providers at all levels. is Guideline should
not be considered exclusive of other methods of care reasonably directed at obtaining the same results.
e ultimate judgment concerning the propriety of any course of conduct must be made by the clinician
aer consideration of each individual patient situation.
Neither IGC, the medical associations, nor the authors endorse any product or service associated with
the distributor of this clinical reference tool.
Abbreviations
AOM, acute otitis media; CHL, conductive hearing loss; COME, chronic otitis media with
effusion; MEE, middle ear effusion; OME, otitis media with effusion; SNHL, sensorineural
hearing loss; TTO, tympanostomy tube otorrhea
Source
Rosenfeld RM , Schwartz SR, Pynnonen MA, et al. Clinical practice guideline: tympanostomy
tubes in children. Otolaryngol Head Neck Surg. 2013;149(1 suppl):S1-S35.
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AAOTYM14033
Evidence Quality and Recommendation Grades
a
Evidence Quality Recommendation
Treatment and Harm Diagnosis Strength
A High-quality RCTs Systematic review
of consistent cross-
sectional studies
S Strong Recommendation
B Consistent RCTs Consistent individual
cross-sectional studies
R Recommendation
C Observational studies Nonconsecutive studies,
case-control studies, or
other studies of poor
quality
O Option
D Case reports, consensus opinions
X Exceptional situations with clear benefit
a
See full text guidelines for details.
