As a member of the state Committee for common childhood diseases, you have been asked to help formulate a policy on the management of chronic otitis media with effusion (also known as glue ear). Glue ear is the most common cause of hearing problems in childhood and can lead to delayed language development. Many treatment choices exited, including grommets (pressure-equalizing tympanostomy tubes), analgesics, antibiotics, vaccinations and hearing aids. However, since glue ear usually resolves spontaneously, you might also choose to do nothing, at least initially. Given these various treatment options, should your committee recommend monitoring for hearing loss, treatment with grommet insertion, or the use of hearing aids? For example, tympanometry, which measures the eardrum ‘ability to move, can be used as a monitoring tool, though an audiogram is needed to confirm the degree of any hearing loss.
1. How do you proceed with formulating a recommendation?
2. How can you systematically approach such a decision?