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

Posted on RAND.org on December 31, 1993

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

Read More

Access further information on this document at jama.jamanetwork.com

This article was published outside of RAND. The full text of the article can be found at the link above.

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.

This report is part of the RAND Corporation External publication series. Many RAND studies are published in peer-reviewed scholarly journals, as chapters in commercial books, or as documents published by other organizations.

Our mission to help improve policy and decisionmaking through research and analysis is enabled through our core values of quality and objectivity and our unwavering commitment to the highest level of integrity and ethical behavior. To help ensure our research and analysis are rigorous, objective, and nonpartisan, we subject our research publications to a robust and exacting quality-assurance process; avoid both the appearance and reality of financial and other conflicts of interest through staff training, project screening, and a policy of mandatory disclosure; and pursue transparency in our research engagements through our commitment to the open publication of our research findings and recommendations, disclosure of the source of funding of published research, and policies to ensure intellectual independence. For more information, visit www.rand.org/about/principles.

The RAND Corporation is a nonprofit institution that helps improve policy and decisionmaking through research and analysis. RAND's publications do not necessarily reflect the opinions of its research clients and sponsors.