Short course motivates tympanometry use in middle ear problems

By Liam Davenport, MedWire Reporter

The use of tympanometry by general practitioners (GPs) in the assessment of children with middle ear problems varies considerably, with some clinicians not using it at all, say Danish researchers.

However, a 6-hour course improved GPs' knowledge and use of the test, they say.

"After the course, the majority (70%) stated that tympanometry often provided important information, and 48% said that tympanometry several times during the past 2 weeks had changed their management of a middle ear problem," notes the team, led by Jørgen Lous, from the University of Southern Denmark in Odense.

Writing in Family Practice, the researchers say: "Our study does not provide the answer to what the optimal use of tympanometry is, but guidelines recommend using tympanometry to qualify the often difficult otoscopy in children and in patients with questionable otoscopy."

Examining data on 702 clinics in two general practice regions in Denmark for 2009, the researchers found that 418 clinics performed a total of 35,529 tympanometries, while 284 clinics performed none at all. The use of tympanometry ranged from 0 to 527 tympanometries per GP per year, at an average of 42.0 per GP per year in those performing tympanometry and 25.2 per GP per year overall.

In a survey of 142 GPs and practice nurses who participated in a 6-hour tympanometry and otitis media course, 34% had not used tympanometry before starting the course and 62% had experienced one or more problems when using it.

Following the course, the number of problems with tympanometry reduced significantly, including a 29.1% reduction in problems associated with interpreting the readout for clinical decisions.

Furthermore, 98% and 95% of participants felt they had gained knowledge on tympanometry and middle ear problems, respectively, while 88% reported learning practical skills. Importantly, 76% of participants said that the course had improved their knowledge on the use of antibiotics.

The team also states that, following the course, only 13% of participants said that the use of tympanometry did not change the management of clinical ear problems, and only 4% had not used it in the past 2 weeks.

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