8
Diagnosis
Table 2. Summary of Guideline Key Diagnostic Action
Statements
Statement Action Strength
1a. Pneumatic
otoscopy
e clinician should document the presence of
middle ear effusion with pneumatic otoscopy
when diagnosing otitis media with effusion
(OME) in a child.
S
1b. Pneumatic
otoscopy
e clinician should perform pneumatic
otoscopy to assess for OME in a child with
otalgia, hearing loss, or both.
S
2. Tympanometry Clinicians should obtain tympanometry in
children with suspected OME for whom the
diagnosis is uncertain aer performing (or
attempting ) pneumatic otoscopy.
S
3. Failed newborn
hearing screen
Clinicians should document in the medical
record counseling of parents of infants with
OME who fail a newborn hearing screen
regarding the importance of follow-up to
ensure that hearing is normal when OME
resolves and to exclude an underlying
sensorineural hearing loss.
R
4a. Child at-risk Clinicians should determine if a child with
OME is at increased risk for speech, language,
or learning problems from middle ear effusion
because of baseline sensory, physical, cognitive,
or behavioral factors (Table 4).
R
4b. Evaluating at- risk
children
Clinicians should evaluate at-risk children
(Table 4) for OME at the time of diagnosis of
an at-risk condition and at 12-18 months of age
(if diagnosed as being at-risk prior to this time).
R
5. Screening healthy
children
Clinicians should NOT routinely screen
children for OME who are not at-risk (Table
4) and do not have symptoms that may
be attributable to OME, such as hearing
difficulties, balance (vestibular) problems, poor
school performance, behavioral problems, or
ear discomfort.
R
(against)
