Predictive value of combinations of otoscopic findings in children with acute ear symptoms

Position of TM	Mobility of TM	Color of TM	Predictive value, %
Combinations with >80% predictive value of AOM compared with myringotomy
Bulging	Distinctly impaired	Cloudy	99
Bulging	Slightly impaired	Cloudy	99
Bulging	Distinctly impaired	Distinctly red	94
Bulging	Slightly impaired	Slightly red	93
Bulging	Distinctly impaired	Slightly red	85
Bulging	Slightly impaired	Distinctly red	83
Normal	Distinctly impaired	Cloudy	97
Normal	Distinctly impaired	Distinctly red	89
Combinations with <50% predictive value of AOM compared with myringotomy
Normal	Slightly impaired	Distinctly red	47
Normal	Slightly impaired	Slightly red	41
Normal	Normal	Cloudy	37
Normal	Normal	Distinctly red	15
Normal	Normal	Slightly red	7
Normal	Normal	Normal	0.1
Retracted	Distinctly impaired	Normal	29
Retracted	Slightly impaired	Normal	3

TM: tympanic membrane.

Data from:
Pelton, SI. Otoscopy for the diagnosis of otitis media. Pediatr Infect Dis J 1998; 17:540.
Karma, PH, Sipila, MM, Kayaja, MJ, Penttila, MA. Pneumatic otoscopy and otitis media: The value of different tympanic membrane findings and their combinations. In: Recent advances in otitis media: proceedings of the Fifth International Symposium, Lim, DJ, Bluestone, CD, Klein, JO, et al (Eds), Decker, Burlington, Ontario, Canada, 1993. p. 41.

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Predictive value of combinations of otoscopic findings in children with acute ear symptoms