title: Variation in rates of diagnosis of acute otitis media.
abstract: Over 13 weeks during two periods in 1978 the diagnostic rate for acute otitis media was monitored among febrile children (aged one to five years) in the emergency room of a large children's hospital. Of the total 228 eligible children, 53 (23 percent) were diagnosed as having otitis media. The observed variation in the weekly diagnostic rates was significantly (p < .005) greater than that expected if the diagnosis rate were a constant 23 percent. Temporal variation in diagnostic rates was largely attributable to differences among individual providers and independent of level of training. For junior residents short-term learning, within the seven-week emergency room rotation, contributed significantly to the week-to-week temporal variation in diagnostic rates for acute otitis media.
mesh_terms: D000208:Acute Disease; D001900:Boston; D002675:Child, Preschool; D002983:Clinical Competence; D004636:Emergency Service, Hospital; D006801:Humans; D007223:Infant; D007396:Internship and Residency; D007858:Learning; D009722:Nurse Practitioners; D010033:Otitis Media / Q000175:diagnosis* / Q000453:epidemiology