ArticleAnnals of family medicine
Cost-effectiveness analysis of treatment options for acute otitis media.
Article in Annals of family medicine. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 16 papers, 1 of them a synthesis that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
16 citing papers in PubMed, 1 synthesis or guideline pooled it, 43 citations in OpenAlex.
- Shorter versus longer antibiotic therapy for children with acute otitis media: A systematic review.European journal of pediatrics · 2026Pooled it
- Cost-Benefit Analysis of Increasing the Exclusive Breastfeeding Rate in Italy.Journal of preventive medicine and hygiene · 2026Article
- Global, regional, and national epidemiology of otitis media in children from 1990 to 2021.Frontiers in pediatrics · 2025Article
- A Cost-Effectiveness Analysis of Population-Level Dental Caries Prevention Strategies in US Children.Academic pediatrics · 2024Article
- A trial-based cost-effectiveness analysis of antibiotic prescription strategies for non-complicated respiratory tract infections in children.BMC pediatrics · 2023Article
- Nasopharyngeal rapid diagnostic testing to reduce unnecessary antibiotic use and individualize management of acute otitis media.Antimicrobial stewardship & healthcare epidemiology : ASHE · 2023Article
- Effects of reactive oxygen species generation induced by Wonju City particulate matter on mitochondrial dysfunction in human middle ear cell.Environmental science and pollution research international · 2021Article
- Antibiotic modulation of mucins in otitis media; should this change our approach to watchful waiting?International journal of pediatric otorhinolaryngology · 2019Article
- Optimisation of peptides that actively cross the tympanic membrane by random amino acid extension: a phage display study.Journal of drug targeting · 2018Article
- Value within otolaryngology: Assessment of the cost-utility analysis literature.World journal of otorhinolaryngology - head and neck surgery · 2016Review
- Article
- Air pollution and emergency department visits for otitis media: a case-crossover study in Edmonton, Canada.Environmental health perspectives · 2010Article
- Health Economics of Antibiotics.Pharmaceuticals (Basel, Switzerland) · 2010Review
- Ear discharge in children presenting with acute otitis media: observational study from UK general practice.The British journal of general practice : the journal of the Royal College of General Practitioners · 2010Article
- Study of the impact of oseltamivir on the risk for pneumonia and other outcomes of influenza, 2000-2005.Medscape journal of medicine · 2008Article
- Assessment of the light intensity of otoscopes utilized in teaching hospitals.Brazilian journal of otorhinolaryngologyArticle
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
1 author at 1 institution in 1 country.
Funding
No grant is acknowledged in the PubMed record.
Abstract
purposeThis study evaluated the costs and utility of observation and routine antibiotic treatment options for children with acute otitis media.
methodsThe cost-effectiveness analysis was performed among children aged 6 months to 12 years seen in primary care offices. The interventions studied were watchful waiting as practiced in the Netherlands, delayed prescription, 5 days of amoxicillin, and 7 to 10 days of amoxicillin. The main outcome measure was cost per quality-adjusted life-year (QALY).
resultsIn the base case analysis, delayed prescription was the least costly option and 7 to 10 days of amoxicillin was the most effective. The incremental cost utility ratio (ICUR) of 7 to 10 days of amoxicillin compared with delayed prescription was 56,000 dollars per QALY gained. Watchful waiting and 5 days of amoxicillin were inferior options. The results were sensitive to the rate of nonattendance in the delayed prescription strategy: when the rate was less than 23%, watchful waiting was the least costly option and delayed prescription was an inferior option. Probabilistic sensitivity analysis, in which all model variables were simultaneously varied, showed with 95% certainty that compared with delayed prescription, 7 to 10 days of amoxicillin had a 61% probability of having an ICUR of greater than 50,000 dollars per QALY gained, and watchful waiting had a 23% probability of having an ICUR of less than 50,000 dollars per QALY gained.
conclusionsEconomically, an approach to the treatment of acute otitis media with either an initial period of observation or routine treatment with amoxicillin is reasonable.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.