Agreement between diagnoses of otitis media by audiologists and otolaryngologists in Aboriginal Australian children

Hasantha Gunasekera, Hilary M. Miller, Leonie Burgess, Shingisai Chando, Simone L. Sheriff, Julie D. Tsembis, Kelvin M. Kong, Harvey L.C. Coates, John Curotta, Kathleen Falster, Peter B. McIntyre, Emily Banks, Natasha J. Peter, Jonathan C. Craig

Research output: Contribution to journalArticle

2 Citations (Scopus)

Abstract

Objectives: To determine the degree of agreement of diagnoses by audiologists and otolaryngologists of otitis media (OM) in Aboriginal children. Design: Cross-sectional study of agreement between diagnoses. Setting: Study of Environment on Aboriginal Resilience and Child Health (SEARCH), a prospective cohort study of Aboriginal children attending four Aboriginal Community Controlled Health Services in New South Wales (three metropolitan, one regional) during 2008-2012. Participants: 1310 of 1669 SEARCH participants (78.5%; mean age, 7.0 years; SD, 4.4 years) were assessed and received a diagnosis from one of five experienced audiologists. Test results (but not case histories) were forwarded to one of three otolaryngologists for blinded independent assessment. Main outcome measures: Agreement of OM diagnoses by audiologists and otolaryngologists at ear and child levels; correctness of audiologist diagnoses (otolaryngologist diagnosis as reference). Results: Paired diagnoses by audiologists and otolaryngologists were available for 863 children at the child level and 1775 ears (989 children) at the ear level. Otolaryngologists diagnosed OM in 251 children (29.1%), including 11 (1.3%) with tympanic membrane perforation, and in 396 ears (22.3%), including 12 (0.7%) with perforation. Agreement between audiologists and otolaryngologists for OM at the ear level was 92.2% (K = 0.78; 95% CI, 0.74-0.82), and at the child level 91.7% (K = 0.81; 95% CI, 0.77-0.85). No otolaryngologist-diagnosed perforation was missed by audiologists. Among 1000 children triaged by an audiologist, there would be 45 false positives and 30 false negatives when compared with assessments by an otolaryngologist, with no missed perforations. Conclusions: There was substantial agreement between audiologists’ and otolaryngologists’ diagnoses of OM in a high prevalence population of Aboriginal children. In settings with limited access to otolaryngologists, audiologists may appropriately triage children and select those requiring specialist review.

Original languageEnglish
Pages (from-to)29-35
Number of pages7
JournalMedical Journal of Australia
Volume209
Issue number1
DOIs
Publication statusPublished - 2 Jul 2018

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Otitis Media
Ear
Otolaryngologists
Audiologists
Tympanic Membrane Perforation
Community Health Services
New South Wales
Triage
Cohort Studies
Cross-Sectional Studies
Outcome Assessment (Health Care)
Prospective Studies

Cite this

Gunasekera, H., Miller, H. M., Burgess, L., Chando, S., Sheriff, S. L., Tsembis, J. D., ... Craig, J. C. (2018). Agreement between diagnoses of otitis media by audiologists and otolaryngologists in Aboriginal Australian children. Medical Journal of Australia, 209(1), 29-35. https://doi.org/10.5694/mja18.00249
Gunasekera, Hasantha ; Miller, Hilary M. ; Burgess, Leonie ; Chando, Shingisai ; Sheriff, Simone L. ; Tsembis, Julie D. ; Kong, Kelvin M. ; Coates, Harvey L.C. ; Curotta, John ; Falster, Kathleen ; McIntyre, Peter B. ; Banks, Emily ; Peter, Natasha J. ; Craig, Jonathan C. / Agreement between diagnoses of otitis media by audiologists and otolaryngologists in Aboriginal Australian children. In: Medical Journal of Australia. 2018 ; Vol. 209, No. 1. pp. 29-35.
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abstract = "Objectives: To determine the degree of agreement of diagnoses by audiologists and otolaryngologists of otitis media (OM) in Aboriginal children. Design: Cross-sectional study of agreement between diagnoses. Setting: Study of Environment on Aboriginal Resilience and Child Health (SEARCH), a prospective cohort study of Aboriginal children attending four Aboriginal Community Controlled Health Services in New South Wales (three metropolitan, one regional) during 2008-2012. Participants: 1310 of 1669 SEARCH participants (78.5{\%}; mean age, 7.0 years; SD, 4.4 years) were assessed and received a diagnosis from one of five experienced audiologists. Test results (but not case histories) were forwarded to one of three otolaryngologists for blinded independent assessment. Main outcome measures: Agreement of OM diagnoses by audiologists and otolaryngologists at ear and child levels; correctness of audiologist diagnoses (otolaryngologist diagnosis as reference). Results: Paired diagnoses by audiologists and otolaryngologists were available for 863 children at the child level and 1775 ears (989 children) at the ear level. Otolaryngologists diagnosed OM in 251 children (29.1{\%}), including 11 (1.3{\%}) with tympanic membrane perforation, and in 396 ears (22.3{\%}), including 12 (0.7{\%}) with perforation. Agreement between audiologists and otolaryngologists for OM at the ear level was 92.2{\%} (K = 0.78; 95{\%} CI, 0.74-0.82), and at the child level 91.7{\%} (K = 0.81; 95{\%} CI, 0.77-0.85). No otolaryngologist-diagnosed perforation was missed by audiologists. Among 1000 children triaged by an audiologist, there would be 45 false positives and 30 false negatives when compared with assessments by an otolaryngologist, with no missed perforations. Conclusions: There was substantial agreement between audiologists’ and otolaryngologists’ diagnoses of OM in a high prevalence population of Aboriginal children. In settings with limited access to otolaryngologists, audiologists may appropriately triage children and select those requiring specialist review.",
author = "Hasantha Gunasekera and Miller, {Hilary M.} and Leonie Burgess and Shingisai Chando and Sheriff, {Simone L.} and Tsembis, {Julie D.} and Kong, {Kelvin M.} and Coates, {Harvey L.C.} and John Curotta and Kathleen Falster and McIntyre, {Peter B.} and Emily Banks and Peter, {Natasha J.} and Craig, {Jonathan C.}",
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Gunasekera, H, Miller, HM, Burgess, L, Chando, S, Sheriff, SL, Tsembis, JD, Kong, KM, Coates, HLC, Curotta, J, Falster, K, McIntyre, PB, Banks, E, Peter, NJ & Craig, JC 2018, 'Agreement between diagnoses of otitis media by audiologists and otolaryngologists in Aboriginal Australian children' Medical Journal of Australia, vol. 209, no. 1, pp. 29-35. https://doi.org/10.5694/mja18.00249

Agreement between diagnoses of otitis media by audiologists and otolaryngologists in Aboriginal Australian children. / Gunasekera, Hasantha; Miller, Hilary M.; Burgess, Leonie; Chando, Shingisai; Sheriff, Simone L.; Tsembis, Julie D.; Kong, Kelvin M.; Coates, Harvey L.C.; Curotta, John; Falster, Kathleen; McIntyre, Peter B.; Banks, Emily; Peter, Natasha J.; Craig, Jonathan C.

In: Medical Journal of Australia, Vol. 209, No. 1, 02.07.2018, p. 29-35.

Research output: Contribution to journalArticle

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AU - Chando, Shingisai

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