{"id":"https://openalex.org/W2610667494","doi":"https://doi.org/10.1542/peds.2017-0667","title":"Prevention and Treatment of Tympanostomy Tube Otorrhea: A Meta-analysis","display_name":"Prevention and Treatment of Tympanostomy Tube Otorrhea: A Meta-analysis","publication_year":2017,"publication_date":"2017-05-05","ids":{"openalex":"https://openalex.org/W2610667494","doi":"https://doi.org/10.1542/peds.2017-0667","mag":"2610667494","pmid":"https://pubmed.ncbi.nlm.nih.gov/28562289"},"language":"en","primary_location":{"id":"doi:10.1542/peds.2017-0667","doi":"https://doi.org/10.1542/peds.2017-0667","is_oa":false,"landing_page_url":"https://doi.org/10.1542/peds.2017-0667","pdf_url":null,"source":{"id":"https://openalex.org/S77494981","display_name":"PEDIATRICS","issn_l":"0031-4005","issn":["0031-4005","1098-4275"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","dongbi-a","doyens","erih-plus","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315734","host_organization_name":"American Academy of Pediatrics","host_organization_lineage":["https://openalex.org/P4310315734"],"host_organization_lineage_names":["American Academy of Pediatrics"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Pediatrics","raw_type":"journal-article"},"volume":null,"type":"review","indexed_in":["crossref","pubmed"],"open_access":{"is_oa":false,"oa_status":"closed","oa_url":null,"any_repository_has_fulltext":false},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5077272405","display_name":"Dale W. Steele","orcid":"https://orcid.org/0000-0002-5689-0255","observed_orcids":["https://orcid.org/0000-0002-5689-0255"]},"institutions":[{"id":"https://openalex.org/I27804330","display_name":"Brown University","ror":"https://ror.org/05gq02987","country_code":"US","type":"education","lineage":["https://openalex.org/I27804330"]},{"id":"https://openalex.org/I4210112379","display_name":"Hasbro Children's Hospital","ror":"https://ror.org/01xq02v66","country_code":"US","type":"healthcare","lineage":["https://openalex.org/I2800446032","https://openalex.org/I4210112379","https://openalex.org/I4210151747"]}],"countries":["US"],"is_corresponding":false,"raw_author_name":"Dale W. Steele","raw_affiliation_strings":["Departments of Health Services, Policy and Practice, School of Public Health,","Emergency Medicine, Section of Pediatrics\u2013Hasbro Children\u2019s Hospital, and","Evidence-Based Practice Center, Center for Evidence Synthesis in Health, and","Pediatrics, Alpert Medical School, Brown University, Providence, Rhode Island"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Departments of Health Services, Policy and Practice, School of Public Health,","institution_ids":[]},{"raw_affiliation_string":"Emergency Medicine, Section of Pediatrics\u2013Hasbro Children\u2019s Hospital, and","institution_ids":["https://openalex.org/I4210112379"]},{"raw_affiliation_string":"Evidence-Based Practice Center, Center for Evidence Synthesis in Health, and","institution_ids":[]},{"raw_affiliation_string":"Pediatrics, Alpert Medical School, Brown University, Providence, Rhode Island","institution_ids":["https://openalex.org/I27804330"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5011120853","display_name":"Gaelen P. Adam","orcid":"https://orcid.org/0000-0002-1103-9205","observed_orcids":["https://orcid.org/0000-0002-1103-9205"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Gaelen P. Adam","raw_affiliation_strings":["Evidence-Based Practice Center, Center for Evidence Synthesis in Health, and"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Evidence-Based Practice Center, Center for Evidence Synthesis in Health, and","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5067497285","display_name":"Mengyang Di","orcid":"https://orcid.org/0000-0001-6165-2617","observed_orcids":["https://orcid.org/0000-0001-6165-2617"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Mengyang Di","raw_affiliation_strings":["Evidence-Based Practice Center, Center for Evidence Synthesis in Health, and"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Evidence-Based Practice Center, Center for Evidence Synthesis in Health, and","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5063073264","display_name":"Christopher W. Halladay","orcid":"https://orcid.org/0000-0002-2890-9107","observed_orcids":["https://orcid.org/0000-0002-2890-9107"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Christopher W. Halladay","raw_affiliation_strings":["Evidence-Based Practice Center, Center for Evidence Synthesis in Health, and"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Evidence-Based Practice Center, Center for Evidence Synthesis in Health, and","institution_ids":[]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5000950219","display_name":"Ethan M. Balk","orcid":"https://orcid.org/0000-0002-4376-7290","observed_orcids":["https://orcid.org/0000-0002-4376-7290"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Ethan M. Balk","raw_affiliation_strings":["Departments of Health Services, Policy and Practice, School of Public Health,","Evidence-Based Practice Center, Center for Evidence Synthesis in Health, and","Departments of Health Services, Policy and Practice, School of Public Health,; Evidence-Based Practice Center, Center for Evidence Synthesis in Health, and"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Departments of Health Services, Policy and Practice, School of Public Health,","institution_ids":[]},{"raw_affiliation_string":"Evidence-Based Practice Center, Center for Evidence Synthesis in Health, and","institution_ids":[]},{"raw_affiliation_string":"Departments of Health Services, Policy and Practice, School of Public Health,; Evidence-Based Practice Center, Center for Evidence Synthesis in Health, and","institution_ids":[]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5062268434","display_name":"Thomas A Trikalinos","orcid":"https://orcid.org/0000-0002-3990-1848","observed_orcids":["https://orcid.org/0000-0002-3990-1848"]},"institutions":[],"countries":[],"is_corresponding":false,"raw_author_name":"Thomas A. Trikalinos","raw_affiliation_strings":["Departments of Health Services, Policy and Practice, School of Public Health,","Evidence-Based Practice Center, Center for Evidence Synthesis in Health, and","Departments of Health Services, Policy and Practice, School of Public Health,; Evidence-Based Practice Center, Center for Evidence Synthesis in Health, and"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"Departments of Health Services, Policy and Practice, School of Public Health,","institution_ids":[]},{"raw_affiliation_string":"Evidence-Based Practice Center, Center for Evidence Synthesis in Health, and","institution_ids":[]},{"raw_affiliation_string":"Departments of Health Services, Policy and Practice, School of Public Health,; Evidence-Based Practice Center, Center for Evidence Synthesis in Health, and","institution_ids":[]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":2,"corresponding_author_ids":[],"corresponding_institution_ids":[],"apc_list":null,"apc_paid":null,"fwci":0.4722,"has_fulltext":false,"cited_by_count":30,"citation_normalized_percentile":{"value":0.38135593,"is_in_top_1_percent":false,"is_in_top_10_percent":false},"cited_by_percentile_year":{"min":89,"max":98},"biblio":{"volume":"139","issue":"6","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T10861","display_name":"Ear Surgery and Otitis Media","score":0.9980000257492065,"subfield":{"id":"https://openalex.org/subfields/2733","display_name":"Otorhinolaryngology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T10861","display_name":"Ear Surgery and Otitis Media","score":0.9980000257492065,"subfield":{"id":"https://openalex.org/subfields/2733","display_name":"Otorhinolaryngology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12297","display_name":"Otolaryngology and Infectious Diseases","score":0.0005000000237487257,"subfield":{"id":"https://openalex.org/subfields/2725","display_name":"Infectious Diseases"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T13770","display_name":"Pediatric health and respiratory diseases","score":9.999999747378752e-05,"subfield":{"id":"https://openalex.org/subfields/3604","display_name":"Emergency Medical Services"},"field":{"id":"https://openalex.org/fields/36","display_name":"Health Professions"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/tympanostomy-tubes","display_name":"tympanostomy tubes","score":0.8960000276565552},{"id":"https://openalex.org/keywords/otorrhea","display_name":"otorrhea","score":0.9440000057220459},{"id":"https://openalex.org/keywords/earplugs","display_name":"earplugs","score":0.9089999794960022},{"id":"https://openalex.org/keywords/swimming","display_name":"swimming","score":0.8019999861717224},{"id":"https://openalex.org/keywords/topical-antibiotics","display_name":"topical antibiotics","score":0.8560000061988831},{"id":"https://openalex.org/keywords/topical-corticosteroids","display_name":"topical corticosteroids","score":0.8050000071525574},{"id":"https://openalex.org/keywords/oral-antibiotics","display_name":"oral antibiotics","score":0.9120000004768372},{"id":"https://openalex.org/keywords/children","display_name":"children","score":0.4819999933242798},{"id":"https://openalex.org/keywords/otitis-media-with-effusion","display_name":"otitis media with effusion","score":0.6970000267028809}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.965653657913208},{"id":"https://openalex.org/C2777315031","wikidata":"https://www.wikidata.org/wiki/Q452921","display_name":"Tympanostomy tube","level":3,"score":0.7647169828414917},{"id":"https://openalex.org/C168563851","wikidata":"https://www.wikidata.org/wiki/Q1436668","display_name":"Randomized controlled trial","level":2,"score":0.6974203586578369},{"id":"https://openalex.org/C44249647","wikidata":"https://www.wikidata.org/wiki/Q208498","display_name":"Confidence interval","level":2,"score":0.6332851052284241},{"id":"https://openalex.org/C82789193","wikidata":"https://www.wikidata.org/wiki/Q2142611","display_name":"Relative risk","level":3,"score":0.5317159295082092},{"id":"https://openalex.org/C156957248","wikidata":"https://www.wikidata.org/wiki/Q1862216","display_name":"Odds ratio","level":2,"score":0.5191653966903687},{"id":"https://openalex.org/C95190672","wikidata":"https://www.wikidata.org/wiki/Q815382","display_name":"Meta-analysis","level":2,"score":0.4421485960483551},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.3576943874359131},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.33556365966796875},{"id":"https://openalex.org/C177713679","wikidata":"https://www.wikidata.org/wiki/Q679690","display_name":"Intensive care medicine","level":1,"score":0.33333301544189453},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.3195589780807495},{"id":"https://openalex.org/C2776439223","wikidata":"https://www.wikidata.org/wiki/Q480700","display_name":"Otitis","level":2,"score":0.05839204788208008}],"mesh":[{"descriptor_ui":"D001494","descriptor_name":"Baths","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D002648","descriptor_name":"Child","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D004427","descriptor_name":"Ear Diseases","qualifier_ui":"Q000517","qualifier_name":"prevention & control","is_major_topic":true},{"descriptor_ui":"D004430","descriptor_name":"Ear Protective Devices","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D006801","descriptor_name":"Humans","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false},{"descriptor_ui":"D008876","descriptor_name":"Middle Ear Ventilation","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D010034","descriptor_name":"Otitis Media with Effusion","qualifier_ui":"Q000517","qualifier_name":"prevention & control","is_major_topic":false},{"descriptor_ui":"D013550","descriptor_name":"Swimming","qualifier_ui":null,"qualifier_name":null,"is_major_topic":true},{"descriptor_ui":"D014867","descriptor_name":"Water","qualifier_ui":null,"qualifier_name":null,"is_major_topic":false}],"locations_count":2,"locations":[{"id":"doi:10.1542/peds.2017-0667","doi":"https://doi.org/10.1542/peds.2017-0667","is_oa":false,"landing_page_url":"https://doi.org/10.1542/peds.2017-0667","pdf_url":null,"source":{"id":"https://openalex.org/S77494981","display_name":"PEDIATRICS","issn_l":"0031-4005","issn":["0031-4005","1098-4275"],"is_oa":false,"is_in_doaj":false,"is_core":true,"listed_in":["anvur-class-a","anvur-scientific","cwts-core","dongbi-a","doyens","erih-plus","jufo-3","ki-jl-3","medline","norway-2","poland-200","russia-white-list-1","vabb-shw"],"host_organization":"https://openalex.org/P4310315734","host_organization_name":"American Academy of Pediatrics","host_organization_lineage":["https://openalex.org/P4310315734"],"host_organization_lineage_names":["American Academy of Pediatrics"],"type":"journal"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Pediatrics","raw_type":"journal-article"},{"id":"pmid:28562289","doi":null,"is_oa":false,"landing_page_url":"https://pubmed.ncbi.nlm.nih.gov/28562289","pdf_url":null,"source":{"id":"https://openalex.org/S4306525036","display_name":"PubMed","issn_l":null,"issn":null,"is_oa":false,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":null,"license_id":null,"version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Pediatrics","raw_type":"Journal Article"}],"best_oa_location":null,"sustainable_development_goals":[{"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being","score":1.0}],"study_designs":[{"id":"https://openalex.org/study-designs/systematic-review","display_name":"Systematic Review"},{"id":"https://openalex.org/study-designs/meta-analysis","display_name":"Meta-Analysis"}],"awards":[],"funders":[],"has_content":{"pdf":false,"grobid_xml":false},"content_urls":null,"referenced_works_count":38,"referenced_works":["https://openalex.org/W68436435","https://openalex.org/W94216050","https://openalex.org/W125351613","https://openalex.org/W228347711","https://openalex.org/W1965558315","https://openalex.org/W1972387284","https://openalex.org/W1974418656","https://openalex.org/W1984079328","https://openalex.org/W2000886563","https://openalex.org/W2007457968","https://openalex.org/W2010129238","https://openalex.org/W2017787400","https://openalex.org/W2043073704","https://openalex.org/W2064242809","https://openalex.org/W2079421930","https://openalex.org/W2079432616","https://openalex.org/W2081606352","https://openalex.org/W2098923148","https://openalex.org/W2100053037","https://openalex.org/W2103433848","https://openalex.org/W2110128234","https://openalex.org/W2120771911","https://openalex.org/W2139168999","https://openalex.org/W2141871140","https://openalex.org/W2150529573","https://openalex.org/W2153115996","https://openalex.org/W2161817962","https://openalex.org/W2167356291","https://openalex.org/W2229802822","https://openalex.org/W2289318348","https://openalex.org/W2321788435","https://openalex.org/W2374757979","https://openalex.org/W2414718070","https://openalex.org/W2415699765","https://openalex.org/W2435871246","https://openalex.org/W2489380320","https://openalex.org/W2552251655","https://openalex.org/W2605667004"],"related_works":["https://openalex.org/W2767053562","https://openalex.org/W2894644727","https://openalex.org/W2110128234","https://openalex.org/W2939421893","https://openalex.org/W2079421930","https://openalex.org/W1502526177","https://openalex.org/W2374757979","https://openalex.org/W2077944986","https://openalex.org/W2049005018","https://openalex.org/W2775076043"],"abstract_inverted_index":{"CONTEXT:":[0],"Children":[1],"with":[2,35],"tympanostomy":[3,36],"tubes":[4],"often":[5],"develop":[6],"ear":[7,95],"discharge.":[8],"OBJECTIVE:":[9],"Synthesize":[10],"evidence":[11,186,218],"about":[12],"the":[13,43,58,163,170,179],"need":[14,221],"for":[15,111,127,153,194,222,230],"water":[16,199,223],"precautions":[17,99,224],"(ear":[18],"plugs":[19,96],"or":[20],"swimming":[21],"avoidance)":[22],"and":[23,48,57,63,70,166,174,189,206,211],"effectiveness":[24],"of":[25,31,51,105,114,121,177,192,219],"topical":[26,139,164,231],"versus":[27,97,129],"oral":[28,137,234],"antibiotic":[29],"treatment":[30],"otorrhea":[32],"in":[33,41,90],"children":[34,91],"tubes.":[37],"DATA":[38,78],"SOURCES:":[39],"Searches":[40],"Medline,":[42],"Cochrane":[44,49],"Central":[45],"Trials":[46],"Registry":[47],"Database":[50],"Systematic":[52],"Reviews,":[53],"Excerpta":[54],"Medica":[55],"Database,":[56],"Cumulative":[59],"Index":[60],"to":[61,93,136],"Nursing":[62],"Allied":[64],"Health":[65],"Literature.":[66],"STUDY":[67],"SELECTION:":[68],"Abstracts":[69],"full-text":[71],"articles":[72,81],"independently":[73],"screened":[74],"by":[75],"2":[76],"investigators.":[77],"EXTRACTION:":[79],"25":[80],"were":[82,142],"included.":[83],"RESULTS:":[84],"One":[85],"randomized":[86,185],"controlled":[87],"trial":[88],"(RCT)":[89],"assigned":[92],"use":[94],"no":[98],"reported":[100,118],"an":[101,119],"odds":[102],"ratio":[103],"(OR)":[104],"0.68":[106],"(95%":[107,123,147,158],"confidence":[108,124],"interval,":[109,125,149,160],"0.37-1.25)":[110],">1":[112],"episode":[113],"otorrhea.":[115],"Another":[116],"RCT":[117],"OR":[120,145,152],"0.71":[122],"0.29-1.76)":[126],"nonswimmers":[128],"swimmers.":[130],"Network":[131],"meta-analyses":[132],"suggest":[133],"that,":[134],"relative":[135],"antibiotics,":[138],"antibiotic-glucocorticoid":[140,165],"drops":[141,155,232],"more":[143],"effective:":[144],"5.3":[146],"credible":[148,159],"1.2-27).":[150],"The":[151],"antibiotic-only":[154,167],"was":[156],"3.3":[157],"0.74-16).":[161],"Overall,":[162],"preparations":[168],"have":[169],"highest":[171],"probabilities,":[172],"0.77":[173],"0.22":[175],"respectively,":[176],"being":[178],"most":[180],"effective":[181],"therapies.":[182],"LIMITATIONS:":[183],"Sparse":[184],"(2":[187],"RCTs)":[188],"high":[190],"risk":[191],"bias":[193],"nonrandomized":[195],"comparative":[196],"studies":[197],"evaluating":[198],"precautions.":[200],"Otorrhea":[201],"treatments":[202],"include":[203],"non-US":[204],"Food":[205],"Drug":[207],"Administration":[208],"approved,":[209],"off-label,":[210],"potentially":[212],"ototoxic":[213],"antibiotics.":[214,235],"CONCLUSIONS:":[215],"No":[216],"compelling":[217],"a":[220],"exists.":[225],"Cure":[226],"rates":[227],"are":[228],"higher":[229],"than":[233]},"counts_by_year":[{"year":2026,"cited_by_count":1},{"year":2025,"cited_by_count":2},{"year":2024,"cited_by_count":4},{"year":2023,"cited_by_count":2},{"year":2022,"cited_by_count":7},{"year":2021,"cited_by_count":6},{"year":2020,"cited_by_count":3},{"year":2019,"cited_by_count":1},{"year":2018,"cited_by_count":4}],"updated_date":"2026-10-31T12:09:11.096373","created_date":"2017-05-12T00:00:00"}