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March 1, 1995

The Appropriateness of Tympanostomy Tubes for Children

Author Affiliations

West Chester, Pa

JAMA. 1995;273(9):699. doi:10.1001/jama.1995.03520330027022

To the Editor.  —In reading the article by Dr Kleinman and colleagues,1 I was struck by their choice of words to describe the appropriateness or inappropriateness of the surgery for tympanostomy tubes. Specifically, their choice of the word "equivocal" to describe indications for the surgery. In my reading of their article, it seems to me that the "equivocal" indications were indications where expert panelists disagreed, where some rated the surgery as appropriate and others rated it as inappropriate. My interpretation of the word "equivocal" is that the surgery was of marginal appropriateness, and this has a very negative connotation.In their conclusion, they recommend that intervention should be made to reduce inappropriate and equivocal care to improve the quality of care being rendered to our children.Instead, I would recommend that they change the word equivocal to another, less negative word that better describes a difference of opinion among

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