ABSTRACT
Pure tone audiometry was obtained for both ears of 32 children by a general practitioner using a simple audiometer in his surgery, and by audiometricians in a hospital department on the same day. Comparing the worst hearing threshold at any of the three tested frequencies, the general practitioner did not find any ears to hear more than 10 dB better than the hospital (no false negatives). However, there were six false positives (9%) where the general practitioner identified an apparent hearing loss of greater than 15 dB. It is concluded that pure tone audiometry could be carried out accurately in the practice.
Subject(s)
Audiometry, Pure-Tone/standards , Audiometry/standards , Family Practice , Hearing Disorders/diagnosis , Hospital Departments , Child , Child, Preschool , Female , Humans , MaleABSTRACT
Children aged six months to 10 years in one practice who were diagnosed with acute otitis media were examined one, three, six and 12 months after diagnosis by a general practitioner and an otolaryngologist on the same day using pneumatic otoscopy. Tympanometry and pure tone audimetry were also carried out. Tympanograms were combined with the specialist's otoscopy findings to determine whether effusion was present. The outcome categories three months or longer after diagnosis were compared with the otoscopic findings up to that stage.The tympanometry results showed that of the 29 children (31 affected ears), five had evidence of middle ear effusion on all occasions tested, while six were normal throughout, 10 fluctuated and eight followed a resolving pattern. Examination 10-14 days or one month after diagnosis was 75% accurate in predicting effusion after three months. Recommendations are made for the use of the pneumatic otoscope in follow up by general practitioners.
Subject(s)
Acoustic Impedance Tests , Otitis Media with Effusion/diagnosis , Otolaryngology/methods , Child , Child, Preschool , Female , Humans , Infant , MaleSubject(s)
Family Practice/education , Pediatrics/education , Child , Child Health Services , Education, Medical, Graduate , England , HumansABSTRACT
Primary care teams should state the aims of a preventive service and, through performance review, assess whether these aims have been achieved. The paediatric surveillance scheme in one practice is described, and the results of certain intermediate outcome measures are given.
