The Medical Appropriateness of Tympanostomy Tubes Proposed for Children Younger Than 16 Years in the United States

Published In: JAMA, The Journal of the American Medical Association, v. 271, no. 16, Apr. 27, 1994, p. 1250-1255

by Lawrence C. Kleinman, Jacqueline Kosecoff, Robert W. Dubois, Robert H. Brook

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Describes the clinical reasons tympanostomy tubes are proposed for children and assesses their appropriateness. The data were collected by a national utilization review firm between 1990 and 1991 and were based on interviews of both otolaryngologists and primary care physician office staffs. The sample included information on over 6,000 children younger than 16 years old in 49 states. The data were compared with appropriateness indications developed by using the RAND appropriateness method. Results indicated that 42 percent of the ear tubes in the children were considered appropriate, 35 percent were equivocal, and 23 percent were inappropriate. Using these standards, a large percentage of ear tubes could be foregone without harming patients' health.

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