Evidence map›Paper›PMID 32839161›Full record

Trial reportThe British journal of general practice : the journal of the Royal College of General Practitioners2020

Improving pain management in childhood acute otitis media in general practice: a cluster randomised controlled trial of a GP-targeted educational intervention.

Rick T van Uum, Roderick P Venekamp, Nicolaas Pa Zuithoff, Alies Sjoukes, Alma C van de Pol, Anne Gm Schilder, Roger Amj Damoiseaux

Open access · hybridAbstract readRandomized Controlled TrialPragmatic Clinical Trial
PubMed Full text at PMC Publisher
In one paragraph

Trial report in The British journal of general practice : the journal of the Royal College of General Practitioners, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers, 2 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed, 2 pooled it
3.8field-weighted citation impact, top 5% 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

7 citing papers in PubMed, 2 syntheses or guidelines pooled it, 34 citations in OpenAlex.

  1. Tailored interventions to address determinants of practice.The Cochrane database of systematic reviews · 2026
    Pooled it
  2. Pooled it
  3. Trial
  4. Trial
  5. Review
  6. Review
  7. 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 2 institutions in 2 countries.

Rick T van UumJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
Roderick P VenekampJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
Nicolaas Pa ZuithoffJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
Alies SjoukesJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
Alma C van de PolJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
Anne Gm SchilderUniversity College London; National Institute for Health Research research professor evidENT, Ear Institute, University College London Hospitals Biomedical Research Centre, London, UK.
Roger Amj DamoiseauxJulius Center for Health Sciences and Primary Care, University Medical Center Utrecht, Utrecht, the Netherlands.
University Medical Center Utrecht · NLUniversity College London · GB

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundPain management in acute otitis media (AOM) is often suboptimal, potentially leading to unnecessary discomfort, GP reconsultation, and antibiotic prescribing.

aimTo assess the effectiveness of a GP-targeted educational intervention to improve pain management in children with AOM. DESIGN AND

settingPragmatic, cluster randomised controlled trial (RCT). GPs in 37 practices (intervention

methodGPs in practices allocated to the intervention group were trained (online and face-to-face) to discuss pain management with parents using an information leaflet, and prompted to prescribe weight-appropriate dosed paracetamol. Ibuprofen was additionally prescribed if pain control was still insufficient. GPs in the control group provided usual care.

resultsMean ear pain scores over the first 3 days were similar between groups (4.66 versus 4.36; adjusted mean difference = -0.05; 95% confidence intervals [CI] = -0.93 to 0.83), whereas analgesic use, in particular ibuprofen, was higher in the intervention group. The total number of antibiotic prescriptions during the 28-day follow-up was similar (mean rate 0.43 versus 0.47; adjusted rate ratio [aRR] 0.97; 95% CI = 0.68 to 1.38). Parents of children in the intervention group were more likely to reconsult for AOM-related complaints (mean rate 0.70 versus 0.41; aRR 1.73; 95% CI = 1.14 to 2.62).

conclusionAn intervention aimed at improving pain management for AOM increases analgesic use, particularly ibuprofen, but does not provide symptomatic benefit. GPs are advised to carefully weigh the potential benefits of ibuprofen against its possible harms.

Indexed as

General PracticeOtitis MediaAcute DiseaseAnti-Bacterial AgentsChildHumansNetherlandsPain ManagementAnti-Bacterial Agentsacute otitis mediachild healtheducational interventionpain managementprimary care

Identifiers

PMID32839161
PMCPMC7449377
OpenAlexW3080722875

What OpenQuestion holds

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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.