title: Medical decision analysis: indications for tympanostomy tubes in RAOM by age at first episode.
abstract: OBJECTIVE
  To compare utility estimates between tympanostomy tubes (TT) and short-courses of antibiotics in children with recurrent acute otitis media (RAOM) stratified by age at first episode.
  
  
  METHODS
  Formal decision analysis.
  
  
  RESULTS
  The model recommended TT sooner in children with a history of a first episode of AOM occurring early in life. In children over 12 months old at onset, TT were recommended with seven episodes in 24 months, five episodes in 12 months, and three episodes in six months. In children under six months old at onset, TT were recommended with three episodes in 24 months and two episodes in a six-month or 12-month time span.
  
  
  CONCLUSIONS
  Earlier TT may be indicated in children who developed a first episode of AOM at a very young age because of the higher risk of AOM recurrence.
  
  
  CONCLUSIONS
  This study is the first formal decision analysis to compare tympanostomy tubes and short-courses of antibiotics stratified by age at onset of the first AOM episode.
authors.affiliation: Department of Otolaryngology-Head and Neck Surgery, Eastern Virginia Medical School, Norfolk, VA 23507, USA. higgints@evms.edu
authors.forename: Thomas S
authors.initials: TS
authors.lastname: Higgins
authors.forename: Steven J
authors.initials: SJ
authors.lastname: McCabe
authors.forename: Jeffrey M
authors.initials: JM
authors.lastname: Bumpous
authors.forename: Serge
authors.initials: S
authors.lastname: Martinez
mesh_terms: D000208:Acute Disease; D000367:Age Factors; D003657:Decision Making; D003661:Decision Support Techniques; D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008876:Middle Ear Ventilation / Q000295:instrumentation*; D008962:Models, Theoretical; D010033:Otitis Media / Q000601:surgery*; D011379:Prognosis; D012008:Recurrence; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D013997:Time Factors