Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

84 questions · 87 findings · 23 reviews · ENT

No studies found 21 · 24.1%GRADE not reported 0 · 0%Very low 29 · 33.3%Low 26 · 29.9%Moderate 11 · 12.6%High 0 · 0%

Early ventilation tubes vs watchful waiting

Presence/persistence of OME · children aged 6 months to 12 years with otitis media with effusion (OME)

It is very uncertain whether early ventilation tubes changes presence/persistence of OME Randomised by child compared with watchful waiting (treatment later if required) (very low certainty).

1 finding from 1 review

Adenoidectomy and unilateral ventilation tube vs unilateral ventilation tube only

Presence/persistence of OME · children aged 6 months to 12 years with otitis media with effusion (OME)

It is very uncertain whether adenoidectomy and unilateral ventilation tube changes presence or persistence of OME (3 years ‐ long‐term) № of… compared with unilateral ventilation tube only (very low certainty).

1 finding from 1 review

Adenoidectomy and ventilation tubes vs watchful waiting

Presence/persistence of OME · children aged 6 months to 12 years with otitis media with effusion (OME)

It is very uncertain whether adenoidectomy and ventilation tubes changes presence/persistence of OME (at 2 years ‐ long‐term) № of… compared with no treatment/watchful waiting (very low certainty).

1 finding from 1 review

Adenoidectomy (with or without myringotomy) vs watchful waiting

Presence/persistence of OME · children aged 6 months to 12 years with otitis media with effusion (OME)

It is very uncertain whether adenoidectomy (with or without myringotomy) changes presence or persistence of OME ‐ over 12 months № of participants:… compared with no treatment/watchful waiting (very low certainty).

1 finding from 1 review

Adenoidectomy and bilateral ventilation tubes vs bilateral ventilation tubes only

Presence/persistence of OME · children aged 6 months to 12 years with otitis media with effusion (OME)

It is very uncertain whether adenoidectomy and bilateral ventilation tubes changes presence/persistence of OME ‐ over 12 months № of participants: 254… compared with bilateral ventilation tubes only (very low certainty).

1 finding from 1 review

Antibiotics vs placebo

Presence/persistence of OME · children aged 6 months to 12 years with otitis media with effusion (OME)

It is very uncertain whether antibiotics changes presence/persistence of OME compared with placebo (very low certainty).

1 finding from 1 review

Antibiotics vs no treatment

Presence/persistence of OME · children aged 6 months to 12 years with otitis media with effusion (OME)

Antibiotics may leads to lower presence/persistence of OME (up to 3 months) № of participants: 542… compared with no treatment (low certainty).

1 finding from 1 review

Intranasal steroid spray vs no treatment

Presence/persistence of OME · children aged 6 months to 12 years with otitis media with effusion (OME)

It is very uncertain whether topical (intranasal) steroids changes presence/persistence of OME (short‐term); assumed ICC = 0.5 compared with no treatment (very low certainty).

1 finding from 1 review

Intratympanic corticosteroids vs systemic corticosteroids

Change in hearing threshold determined by PTA Range 0 dB to 140 dB Negative values represent lowering and positive values represent raising of the hearing threshold. A lower hearing threshold represents hearing improvement. Â · sudden sensorineural hearing loss

Intratympanic corticosteroids showed no clear difference in change in hearing threshold determined by PTA Range 0 dB to 140 dB… compared with systemic corticosteroids (low certainty).

1 finding from 1 review

Intratympanic plus systemic corticosteroids (combined therapy) vs systemic corticosteroids alone

Change in hearing threshold determined by PTA Range 0 dB to 140 dB Negative values represent lowering and positive values represent raising of the hearing threshold. A lower hearing threshold represents hearing improvement. Â · sudden sensorineural hearing loss

Intratympanic plus systemic corticosteroids (combined therapy) showed no clear difference in change in hearing threshold determined by PTA Range 0 dB to 140 dB… compared with systemic corticosteroids alone (low certainty).

1 finding from 1 review

Intratympanic plus systemic corticosteroids (combined therapy) vs systemic corticosteroids alone

Final hearing threshold determined by PTA (a lower value represents better hearing) · sudden sensorineural hearing loss

It is very uncertain whether intratympanic plus systemic corticosteroids (combined therapy) changes final hearing threshold determined by PTA A lower value represents… compared with systemic corticosteroids alone (very low certainty).

1 finding from 1 review

Intratympanic corticosteroids vs no treatment or versus placebo

Change in hearing threshold determined by PTA Range 0 dB to 140 dB Negative values represent lowering and positive values represent raising of the hearing threshold. A lower hearing threshold represents hearing improvement. Â · sudden sensorineural hearing loss

Intratympanic corticosteroids showed no clear difference in change in hearing threshold determined by PTA Range 0 dB to 140 dB… compared with no treatment or versus placebo (low certainty).

1 finding from 1 review

Intratympanic corticosteroids vs no treatment or versus placebo

Final hearing threshold determined by PTA (a lower value represents better hearing) · sudden sensorineural hearing loss

Intratympanic corticosteroids showed no clear difference in final hearing threshold determined by PTA (a lower value represents… compared with no treatment or versus placebo (low certainty).

1 finding from 1 review

Intratympanic corticosteroids vs systemic corticosteroids

Final hearing threshold determined by PTA (a lower value represents better hearing) · sudden sensorineural hearing loss

Intratympanic corticosteroids showed no clear difference in final hearing threshold determined by PTA (a lower value represents… compared with systemic corticosteroids (low certainty).

1 finding from 1 review