Publication

Acute otitis externa: consensus definition, diagnostic criteria and core outcome set development.

Abstract
Objective: Evidence for the management of acute otitis externa (AOE) is limited, with unclear diagnostic criteria and variably reported outcome measures that may not reflect key stakeholder priorities. We aimed to develop 1) a definition, 2) diagnostic criteria and 3) a core outcome set (COS) for AOE. Study design: COS development according to Core Outcome Measures in Effectiveness Trials (COMET) methodology and parallel consensus selection of diagnostic criteria/definition. Setting: Stakeholders from the United Kingdom. Subjects and methods: Comprehensive literature review identified candidate items for the COS, definition and diagnostic criteria. Nine individuals with past AOE generated further patient-centred candidate items. Candidate items were rated for importance by patient and professional (ENT doctors, general practitioners, microbiologists, nurses, audiologists) stakeholders in a three-round online Delphi exercise. Consensus items were grouped to form the COS, diagnostic criteria, and definition. Results: Candidate COS items from patients (n = 28) and literature (n = 25) were deduplicated and amalgamated to a final candidate list (n = 46). Patients emphasised quality-of-life and the impact on daily activities/work. Via the Delphi process, stakeholders agreed on 31 candidate items. The final COS covered six outcomes: pain; disease severity; impact on quality-of-life and daily activities; patient satisfaction; treatment-related outcome; and microbiology. 14 candidate diagnostic criteria were identified, 8 reaching inclusion consensus. The final definition for AOE was 'diffuse inflammation of the ear canal skin of less than 6 weeks duration'. Conclusion: The development and adoption of a consensus definition, diagnostic criteria and a COS will help to standardise future research in AOE, facilitating meta-analysis. Consulting former patients throughout development highlighted deficiencies in the outcomes adopted previously, in particular concerning the impact of AOE on daily life.
Author
Smith, Matthew E
Hardman, John C
Mehta, Nishchay
Jones, Gareth H
Mandavia, Rishi
Anderson, Caroline
Khan, Maha
Abdelaziz, Aula
Al-Dulaimy, Bakir
Amin, Nikul
Anmolsingh, Rajesh
Anwar, Bilal
Bance, Manohar
Belfield, Katherine
Bhutta, Mahmood
Buchanan, Ruaridh
Chandrasekharan, Deepak
Chu, Michael
Chundu, Srikanth
Conroy, Katherine
Crundwell, Gemma
Daniel, Mat
Daniels, Jessica
De, Sujata
Dobbs, Sian
Doshi, Jayesh
Farr, Matthew
Ferdous, Tanjinah
Fragkouli, Eleni
Freeman, Simon
Ghosh, Samit
Gosnell, Emma
Hannan, S Alam
Heward, Elliot
Javed, Faisal
John, Deepa
Nicholls, Helen
Kasbekar, Anand V
Khan, Haroon
Khan, Hammad
Khwaja, Sadie
Kotecha, Bhik
Krishnan, Madhankumar
Kumar, Nirmal
Lamb, Tamara
Lancer, Hannah
Manjaly, Joseph G
Martinez Del Pero, Marcos
McClenaghan, Fiona
Milinis, Kristijonas
Mistry, Nina
Mohammed, Hassan
Morris, Elizabeth
Morris-Jones, Stephen
Padee, Jessica
Pal, Surojit
Patel, Sanjay
Pericleous, Agamemnon
Qayyum, Asad
Rouhani, Maral
Saeed, Haroon
Santhiyapillai, Mirusanthan
Seymour, Kay
Sharma, Sunil
Siau, Richard
Singh, Arvind
Stapleton, Emma
Stephenson, Kate
Stynes, Gill
Subramanian, Bharathi
Summerfield, Neil
Swords, Chloe
Trinidade, Aaron
Tse, Antonia
Twumasi, Emmanuel
Ubhi, Harmony
Unadkat, Samit
Vijendren, Ananth
Wasson, Joe
Watson, Glen
Williams, Glennis
Wilson, Janet
Yao, Alexander
Youssef, Ahmed
Lloyd, Simon K W
Tysome, James R
Citations
Altmetric:
Date
2021-05-14
Type
Article
Subject
Ear, Nose and Throat
Collections
UHB Ear Nose and Throat
Reports
Show all metadata
Citation
Smith ME, Hardman JC, Mehta N, Jones GH, Mandavia R, Anderson C, Khan M, Abdelaziz A, Al-Dulaimy B, Amin N, Anmolsingh R, Anwar B, Bance M, Belfield K, Bhutta M, Buchanan R, Chandrasekharan D, Chu M, Chundu S, Conroy K, Crundwell G, Daniel M, Daniels J, De S, Dobbs S, Doshi J, Farr M, Ferdous T, Fragkouli E, Freeman S, Ghosh S, Gosnell E, Hannan SA, Heward E, Javed F, John D, Nicholls H, Kasbekar AV, Khan H, Khan H, Khwaja S, Kotecha B, Krishnan M, Kumar N, Lamb T, Lancer H, Manjaly JG, Martinez Del Pero M, McClenaghan F, Milinis K, Mistry N, Mohammed H, Morris E, Morris-Jones S, Padee J, Pal S, Patel S, Pericleous A, Qayyum A, Rouhani M, Saeed H, Santhiyapillai M, Seymour K, Sharma S, Siau R, Singh A, Stapleton E, Stephenson K, Stynes G, Subramanian B, Summerfield N, Swords C, Trinidade A, Tse A, Twumasi E, Ubhi H, Unadkat S, Vijendren A, Wasson J, Watson G, Williams G, Wilson J, Yao A, Youssef A, Lloyd SKW, Tysome JR; INTEGRATE (The UK ENT Trainee Research Network). Acute otitis externa: Consensus definition, diagnostic criteria and core outcome set development. PLoS One. 2021 May 14;16(5):e0251395. doi: 10.1371/journal.pone.0251395
Journal / Source Title
PloS One
DOI
10.1371/journal.pone.0251395
URI
http://hdl.handle.net/20.500.14200/7675
PMID
33989313
Publisher
Public Library of Science
Publisher’s URL
http://www.plosone.org/
Publisher’s statement
Note / Copyright