title: Evidence-based management of otitis media: a 5S model approach.
abstract: OBJECTIVE
  The 5S model proposes five hierarchical levels (systems, summaries, synopses, syntheses and studies) of pre-appraised evidence to guide evidence-based practice. This review aimed to identify and summarise pre-appraised evidence at the highest available 5S level for the management of different subsets of otitis media: acute otitis media, otitis media with effusion, chronic suppurative otitis media and cholesteatoma in both adults and children.
  
  
  METHODS
  Data sources were pre-appraised evidence resources. Evidence freely available from sources at the highest available level of the 5S model were summarised for this review.
  
  
  RESULTS
  System level evidence exists for acute otitis media and otitis media with effusion. Summary level evidence exists for recurrent acute otitis media and medical management of chronic suppurative otitis media. There is an absence of randomised controlled trials to prove the efficacy of surgical management of chronic suppurative otitis media and cholesteatoma.
  
  
  CONCLUSIONS
  Until randomised controlled trial data are generated, consensus publications on the surgical management of chronic suppurative otitis media and cholesteatoma should be used to guide best practice.
authors: Department of Otolaryngology,Ipswich Hospital NHS Trust,Suffolk,UK.
authors: J D
authors: JD
authors: Wasson
authors: Department of Otolaryngology,Ipswich Hospital NHS Trust,Suffolk,UK.
authors: M W
authors: MW
authors: Yung
mesh_terms: D019317:Evidence-Based Medicine; D006801:Humans; D010033:Otitis Media / Q000188:drug therapy / Q000473:pathology / Q000601:surgery / Q000628:therapy*
keywords: Review