title: Danish guidelines on management of otitis media in preschool children.
abstract: Otitis media is one of the most common diseases in small children. This underlines the importance of optimizing diagnostics and treatment of the condition. Recent literature points toward a stricter approach to diagnosing acute otitis media (AOM). Moreover, ventilating tube treatment for recurrent AOM (RAOM) and chronic otitis media with effusion (COME) has become the most frequently performed surgical procedure in pre-school children. Therefore, the Danish Health and Medicines Authority and the Danish Society of Otorhinolaryngology, Head and Neck Surgery deemed it necessary to update the Danish guidelines regarding the diagnostic criteria for acute otitis media and surgical treatment of RAOM and COME.
  
  
  
  The GRADE system (The Grading of Recommendations Assessment, Development and Evaluation) was used in order to comply with current standards of evidence assessment in formulation of recommendations. An extensive literature search was conducted between July and December 2014. The quality of the existing literature was assessed using AGREE II (Appraisal of Guidelines for Research & Evaluation), AMSTAR (assessing the Methodological Quality of Systematic Reviews), QUADAS-2 (Quality of Diagnostic Accuracy Studies), Cochrane Risk of Bias Tool for randomized trials and ACROBAT-NRSI (A Cochrane Risk of Bias Assessment Tool for Non-Randomized Studies). The working group consisted of otolaryngologists, general practitioners, pediatricians, microbiologists and epidemiologists.
  
  
  
  Recommendations for AOM diagnosis, surgical management for RAOM and COME, including the role of adenoidectomy and treatment of ventilating tube otorrhea, are proposed in the guideline.
authors.affiliation: Danish Health and Medicines Authority, Denmark; Department of ENT - Head & Neck Surgery, Odense University Hospital, Denmark; Department of Otorhinolaryngology, Vejle Hospital, Denmark. Electronic address: christian.heidemann@rsyd.dk.
authors.forename: C H
authors.initials: CH
authors.lastname: Heidemann
authors.affiliation: Research Unit for General Practice, Institute of Public Health, University of Southern Denmark, Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Lous
authors.affiliation: ENT Private Clinic, Århus, Denmark.
authors.forename: J
authors.initials: J
authors.lastname: Berg
authors.affiliation: Department of Clinical Microbiology, Slagelse Hospital, Denmark.
authors.forename: J J
authors.initials: JJ
authors.lastname: Christensen
authors.affiliation: Danish Health and Medicines Authority, Denmark; Centre for Clinical Guidelines, Department of Health Science and Technology, University of Aalborg, Denmark.
authors.forename: S J
authors.initials: SJ
authors.lastname: Håkonsen
authors.affiliation: Danish Health and Medicines Authority, Denmark.
authors.forename: M
authors.initials: M
authors.lastname: Jakobsen
authors.affiliation: ENT Private Clinic, Odense, Denmark.
authors.forename: C J
authors.initials: CJ
authors.lastname: Johansen
authors.affiliation: Department of Otorhinolaryngology, Head and Neck Surgery & Audiology, Rigshospitalet, Denmark.
authors.forename: L H
authors.initials: LH
authors.lastname: Nielsen
authors.affiliation: Research Unit for General Practice, Institute of Public Health, University of Southern Denmark, Denmark; Centre for Research in Evidence-Based Practice, Bond University, Australia.
authors.forename: M P
authors.initials: MP
authors.lastname: Hansen
authors.affiliation: Department of Paediatrics and Adolescent Medicine, Rigshospitalet, Denmark.
authors.forename: A
authors.initials: A
authors.lastname: Poulsen
authors.affiliation: Department of Otorhinolaryngology, Vejle Hospital, Denmark.
authors.forename: L P
authors.initials: LP
authors.lastname: Schousboe
authors.affiliation: Danish Health and Medicines Authority, Denmark; Medical Library, Aalborg University Hospital, Denmark.
authors.forename: C
authors.initials: C
authors.lastname: Skrubbeltrang
authors.affiliation: Danish Health and Medicines Authority, Denmark.
authors.forename: A B
authors.initials: AB
authors.lastname: Vind
authors.affiliation: Department of Otorhinolaryngology and Maxillofacial Surgery, Køge University Hospital, Denmark.
authors.forename: P
authors.initials: P
authors.lastname: Homøe
mesh_terms: D000158:Acoustic Impedance Tests; D000208:Acute Disease; D000233:Adenoidectomy; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002675:Child, Preschool; D002908:Chronic Disease; D003718:Denmark; D019468:Disease Management; D006801:Humans; D007223:Infant; D008876:Middle Ear Ventilation; D010033:Otitis Media / Q000175:diagnosis / Q000628:therapy; D010034:Otitis Media with Effusion / Q000175:diagnosis / Q000628:therapy*; D038781:Otoscopy; D012008:Recurrence; D012306:Risk; D057832:Watchful Waiting
chemical_list: D000900:Anti-Bacterial Agents