Roditi Rachel E, Veling Maria, Shin Jennifer J
Harvard Medical School, Boston, Massachusetts.
University of Texas Southwestern Medical Center, Dallas, Texas, U.S.A.
Laryngoscope. 2016 Jul;126(7):1687-92. doi: 10.1002/lary.25682. Epub 2015 Sep 30.
OBJECTIVES/HYPOTHESIS: 1) To determine whether there is a significant relationship between allergic rhinitis and otitis media with effusion (OME), Eustachian tube dysfunction (ETD), or tympanic membrane retraction (TMR) in children in a nationally representative population; and 2) to determine whether age is an effect modifier of any such association because this hypothesis has yet to be tested.
Retrospective analysis of cross-sectional national databases with limited potential for referral bias.
National Ambulatory Medical Care Survey and National Hospital Ambulatory Medical Care Survey, 2005-2010.
Univariate, multivariate, stratified, and subgroup analyses were performed as defined a priori. The primary outcomes were OME, ETD, or TMR; the primary predictor variable was allergic rhinitis, with age evaluated as an effect modifier.
Data representing 1,491,045,375 pediatric visits were examined and demonstrated that age was an effect modifier of the assessed association. More specifically, in children 6 years of age or older, the presence of allergic rhinitis significantly increased the odds of OME, ETD, or TMR (odds ratio [OR] 4.20; 95% confidence interval [CI] 2.17, 8.09; P < 0.001), whereas in children less than 6 years of age there was no significant association (OR 1.13; 95% CI 0.53, 2.46; P = 0.745).
Age is an effect modifier of the association between allergic rhinitis and OME; a significant relationship is observed in children 6 years of age and older, whereas there is no significant association in younger children.
2c. Laryngoscope, 126:1687-1692, 2016.
目的/假设：1）确定在具有全国代表性的儿童群体中，变应性鼻炎与分泌性中耳炎（OME）、咽鼓管功能障碍（ETD）或鼓膜内陷（TMR）之间是否存在显著关联；2）确定年龄是否为任何此类关联的效应修饰因素，因为该假设尚未得到检验。
对具有有限转诊偏倚可能性的全国横断面数据库进行回顾性分析。
2005 - 2010年全国门诊医疗护理调查和全国医院门诊医疗护理调查。
按照预先定义进行单变量、多变量、分层和亚组分析。主要结局为OME、ETD或TMR；主要预测变量为变应性鼻炎，将年龄作为效应修饰因素进行评估。
对代表1491045375次儿科就诊的数据进行了检查，结果表明年龄是所评估关联的效应修饰因素。更具体地说，在6岁及以上儿童中，变应性鼻炎的存在显著增加了发生OME、ETD或TMR的几率（优势比[OR]为4.20；95%置信区间[CI]为2.17, 8.09；P < 0.001），而在6岁以下儿童中则无显著关联（OR为1.13；95% CI为0.53, 2.46；P = 0.745）。
年龄是变应性鼻炎与OME之间关联的效应修饰因素；在6岁及以上儿童中观察到显著关联，而在年幼儿童中无显著关联。
2c。《喉镜》，2016年，第126卷，第1687 - 1692页。
