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Age-specific Patterns of Diagnosis of Acute Otitis Media

Institute for Health Research—a joint venture of The Harvard Community Health Plan and Harvard University, Medford, Massachusetts

D.M. Berwick

Institute for Health Research—a joint venture of The Harvard Community Health Plan and Harvard University, Medford, Massachusetts

M.L. Feldstein

Institute for Health Research—a joint venture of The Harvard Community Health Plan and Harvard University, Medford, Massachusetts

S.S. Marter

Institute for Health Research—a joint venture of The Harvard Community Health Plan and Harvard University, Medford, Massachusetts

A retrospective review of clinical experience with the diagnosis of acute otitis media (AOM) in a large pediatric population (age, 0-12 years old) reveals two age-specific patterns of diagnosis: one in preschool children and one in schoolage children. In the population as a whole, AOM is diagnosed most frequently in the first 5 years of life; rates of diagnosis vary with gender (male: female ratio = 1.10) and season (fall/winter peak). In a linear regression model, age, gender, season, and interactions among these account for 52 percent of the variability in diagnostic rates.

In children less than 5 years of age, rates of diagnosis vary strikingly with gender and season; the regression model accounts for 55 percent of observed variability in diagnostic rates. In schoolage children (5-11 years old), however, males and females are equally likely to be diagnosed to have AOM, and seasonal variability is blunted; among these children, the regression model predicts only 22 percent of diagnostic rate variability.

These findings buttress existing knowledge of the epidemiology of AOM and have important implications for clinical practice, health planning, and pediatric research.

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