Evidence map›Paper›PMID 30223903›Full record

ArticleTrials2018

Optimising pain management in children with acute otitis media through a primary care-based multifaceted educational intervention: study protocol for a cluster randomised controlled trial.

Rick T van Uum, Roderick P Venekamp, Alies Sjoukes, Alma C van de Pol, G Ardine de Wit, Anne G M Schilder, Roger A M J Damoiseaux

Open access · goldAbstract readClinical Trial Protocol
PubMed Full text at PMC Publisher
In one paragraph

Article in Trials, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 5 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
5citing papers in PubMed, 1 pooled it
1.5field-weighted citation impact, top 17% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

5 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Tailored interventions to address determinants of practice.The Cochrane database of systematic reviews · 2026
    Pooled it
  2. Trial
  3. Improving pain management in childhood acute otitis media in general practice: a cluster randomised controlled trial of a GP-targeted educational intervention.The British journal of general practice : the journal of the Royal College of General Practitioners · 2020
    Trial
  4. Article
  5. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

7 authors at 1 institution in 2 countries.

Rick T van UumJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Stratenum 5.143, PO Box 85500, 3508, GA, Utrecht, The Netherlands. r.t.vanuum-2@umcutrecht.nl.ORCID http://orcid.org/0000-0001-9415-4286
Roderick P VenekampJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Stratenum 5.143, PO Box 85500, 3508, GA, Utrecht, The Netherlands.
Alies SjoukesJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Stratenum 5.143, PO Box 85500, 3508, GA, Utrecht, The Netherlands.
Alma C van de PolJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Stratenum 5.143, PO Box 85500, 3508, GA, Utrecht, The Netherlands.
G Ardine de WitJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Stratenum 5.143, PO Box 85500, 3508, GA, Utrecht, The Netherlands.
Anne G M SchilderJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Stratenum 5.143, PO Box 85500, 3508, GA, Utrecht, The Netherlands.
Roger A M J DamoiseauxJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht University, Stratenum 5.143, PO Box 85500, 3508, GA, Utrecht, The Netherlands.
Utrecht University · NL

Funding

Department of Health NIHR-RP-011-045ZonMw 839110005
6 · The paper itself

Abstract

backgroundWhilst current guidelines highlight the importance of pain management for children with acute otitis media (AOM), there is evidence to suggest that this is not implemented in everyday practice. We have developed a primary care-based multifaceted educational intervention to optimise pain management in children with AOM, and we trial its clinical and cost effectiveness.

methodsThis cluster randomised controlled trial aims to recruit 250 children aged 6 months to 10 years presenting with AOM to general practitioners (GPs) in 30 primary care centres (PCCs) across the Netherlands. GPs in the PCCs allocated to the intervention group receive a blended GP educational programme (online and face-to-face training). The intervention asks GPs to proactively discuss pain management with parents using an information leaflet, and to prescribe paracetamol and ibuprofen according to current guidelines. GPs in both groups complete an online module illustrating various otoscopic images to standardise AOM diagnosis. GPs in the PCCs allocated to the control group do not receive any further training and provide 'care as usual'. During the 4-week follow-up, parents complete a symptom diary. The primary outcome is the difference in parent-reported mean earache scores over the first 3 days. Secondary outcomes include both number of days with earache and fever, GP re-consultations for AOM, antibiotic prescriptions, and costs. Analysis will be by intention-to-treat. DISCUSSION: The optimal use of analgesics through the multifaceted intervention may provide symptom relief and thereby reduce re-consultations and antibiotic prescriptions in children with AOM.

trial registrationNetherlands Trial Register, NTR4920 . Registered on 19 December 2014.

Indexed as

Health Knowledge, Attitudes, PracticeAcetaminophenAcute PainAge FactorsAnalgesics, Non-NarcoticChildChild, PreschoolCost-Benefit AnalysisCyclooxygenase InhibitorsEaracheFemaleHealth Care CostsHumansIbuprofenInfantMaleAcetaminophenAnalgesics, Non-NarcoticCyclooxygenase InhibitorsIbuprofenAcute otitis mediaAnalgesicsMultifaceted interventionPain managementPrimary careRCT

Identifiers

PMID30223903
PMCPMC6142388
OpenAlexW2890014946

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.