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September 2007

Spectral Gradient Acoustic Reflectometry Compared With Tympanometry in Diagnosing Middle Ear Effusion in Children Aged 6 to 24 Months

Author Affiliations

Author Affiliations: Division of General Academic Pediatrics, Children's Hospital of Pittsburgh (Drs Chianese, Hoberman, and Paradise and Mss Colborn and Kearney), and Department of Pediatrics, School of Medicine (Drs Chianese, Hoberman, and Paradise) and Graduate School of Public Health (Dr Rockette and Ms Kurs-Lasky), University of Pittsburgh, Pittsburgh, Pennsylvania.

Arch Pediatr Adolesc Med. 2007;161(9):884-888. doi:10.1001/archpedi.161.9.884

Objectives  To evaluate the accuracy of spectral gradient acoustic reflectometry (SGAR) in children aged 6 to 24 months, and to compare SGAR with tympanometry.

Design  Comparison of diagnostic tests.

Setting  Inner-city primary care center in Pittsburgh, Pennsylvania.

Participants  A total of 786 healthy children aged 6 to 24 months.

Main Outcome Measures  Test characteristics of SGAR (sensitivity, specificity, and positive and negative predictive values) and receiver operating characteristic curves from the SGAR and tympanometric data.

Results  The SGAR results were available for 3096 otoscopic examinations in 647 children. Tympanometric results were available for 2854 otoscopic examinations in 597 children. Using the recommended SGAR pass or fail cutoff, 53% of the ears in which effusion was present would have been considered effusion free (sensitivity, 47%). Only 10% of the ears without effusion would have been considered to have effusion (specificity, 90%). The area under the receiver operating characteristic curve was 0.78 for SGAR and 0.83 for tympanometry.

Conclusion  Spectral gradient acoustic reflectometry is slightly less discerning than tympanometry in predicting the presence or absence of middle ear effusion in children younger than 2 years.