title: Spectral gradient acoustic reflectometry compared with tympanometry in diagnosing middle ear effusion in children aged 6 to 24 months.
abstract: OBJECTIVE
  To evaluate the accuracy of spectral gradient acoustic reflectometry (SGAR) in children aged 6 to 24 months, and to compare SGAR with tympanometry.
  
  
  METHODS
  Comparison of diagnostic tests.
  
  
  METHODS
  Inner-city primary care center in Pittsburgh, Pennsylvania.
  
  
  METHODS
  A total of 786 healthy children aged 6 to 24 months.
  
  
  METHODS
  Test characteristics of SGAR (sensitivity, specificity, and positive and negative predictive values) and receiver operating characteristic curves from the SGAR and tympanometric data.
  
  
  RESULTS
  The SGAR results were available for 3096 otoscopic examinations in 647 children. Tympanometric results were available for 2854 otoscopic examinations in 597 children. Using the recommended SGAR pass or fail cutoff, 53% of the ears in which effusion was present would have been considered effusion free (sensitivity, 47%). Only 10% of the ears without effusion would have been considered to have effusion (specificity, 90%). The area under the receiver operating characteristic curve was 0.78 for SGAR and 0.83 for tympanometry.
  
  
  CONCLUSIONS
  Spectral gradient acoustic reflectometry is slightly less discerning than tympanometry in predicting the presence or absence of middle ear effusion in children younger than 2 years.
authors.affiliation: Division of General Academic Pediatrics, Children's Hospital of Pittsburgh, Pittsburgh, PA 15213-2583, USA. jennifer.chianese@chp.edu
authors.forename: Jennifer
authors.initials: J
authors.lastname: Chianese
authors.forename: Alejandro
authors.initials: A
authors.lastname: Hoberman
authors.forename: Jack L
authors.initials: JL
authors.lastname: Paradise
authors.forename: D Kathleen
authors.initials: DK
authors.lastname: Colborn
authors.forename: Diana
authors.initials: D
authors.lastname: Kearney
authors.forename: Howard E
authors.initials: HE
authors.lastname: Rockette
authors.forename: Marcia
authors.initials: M
authors.lastname: Kurs-Lasky
mesh_terms: D000158:Acoustic Impedance Tests / Q000379:methods*; D000162:Acoustics / Q000295:instrumentation; D000465:Algorithms; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D010034:Otitis Media with Effusion / Q000175:diagnosis*; D012372:ROC Curve; D012680:Sensitivity and Specificity