Uhari M, Niemelä M, Hietala J
Department of Pediatrics, University of Oulu, Finland.
Acta Paediatr. 1995 Jan;84(1):90-2. doi: 10.1111/j.1651-2227.1995.tb13493.x.
We carried out a prospective study to analyse if it would be possible to predict the coexistence of acute otitis media on the basis of symptoms and signs of infection. Of the 658 patients admitted to hospital during the period concerned, 197 (29.9%) had otitis media. For each child with otitis, the next patient of the same age was chosen as a control. The risk of having otitis media was increased among patients with cough, rhinitis and earache. All three variables together correctly classified 67% of those not having otitis media and 63% of those with acute otitis, compared with the 50% which would theoretically be achieved by chance alone. Prediction was worst (55%) among patients younger than 2 years of age not having otitis media and best among older patients who had otitis media, i.e. 78%. Prediction on these grounds would have caused significant over-treatment, and one-third of the otitis cases among the youngest group would have been missed. Thus it is important to always examine the ears of a child with an infection in order to reliably exclude the possibility of acute otitis media.
我们进行了一项前瞻性研究，以分析是否有可能根据感染的症状和体征来预测急性中耳炎的并存情况。在相关期间入院的658例患者中，197例（29.9%）患有中耳炎。对于每例患有中耳炎的儿童，选择下一位同年龄的患者作为对照。咳嗽、鼻炎和耳痛患者患中耳炎的风险增加。与仅靠随机猜测理论上能达到的50%相比，这三个变量共同正确分类了67%的非中耳炎患者和63%的急性中耳炎患者。在2岁以下未患中耳炎的患者中预测最差（55%），而在患中耳炎的老年患者中预测最好，即78%。基于这些依据进行预测会导致显著的过度治疗，最年幼组中有三分之一的中耳炎病例会被漏诊。因此，对于感染患儿，始终检查其耳部以可靠排除急性中耳炎的可能性非常重要。
