Findings

What do systematic reviews say?

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Evidence found and GRADE certainty

80 questions · 80 findings · 10 reviews · ENT · Headline outcomes only

No studies found 29 · 36.3%GRADE not reported 2 · 2.5%Very low 14 · 17.5%Low 15 · 18.8%Moderate 18 · 22.5%High 2 · 2.5%

Oral steroids vs placebo

Hearing ‐ return to normal *Ventilation tubes versus laser myringotomy (6 to 12 months ‐ medium‐term) Adjusted for non‐independence of within‐individual measurements Assumed ICC of 0.5 № of participants: 132 (2 RCTs) · children aged 6 months to 12 years with otitis media with effusion (OME)

Oral steroids showed no clear difference in hearing ‐ return to normal hearing compared with placebo (moderate certainty).

1 finding from 1 review

Summary of findings: oral steroids plus antibiotic vs control plus antibiotic

Adverse effects [2 weeks to 6 months] · Children with otitis media with effusion

Summary of findings: oral steroids plus antibiotic showed no clear difference in adverse effects [2 weeks to 6 months] compared with control plus antibiotic (low certainty).

1 finding from 1 review

Summary of findings: oral steroids plus antibiotic vs control plus antibiotic

Hearing loss · Children with otitis media with effusion

Summary of findings: oral steroids plus antibiotic showed no clear difference in hearing loss [2 months]1 compared with control plus antibiotic (moderate certainty).

1 finding from 1 review

Summary of findings: oral steroids plus antibiotic vs control plus antibiotic

OME resolution at short‐term · Children with otitis media with effusion

Summary of findings: oral steroids plus antibiotic leads to higher OME resolution at short‐term compared with control plus antibiotic (high certainty).

1 finding from 1 review