Cost-utility analysis of topical intranasal steroids for otitis media with effusion based on evidence from the GNOME trial.

Objectives: To estimate the cost-effectiveness of topical intranasal steroids for the treatment of otitis media with effusion (OME) in primary care from the perspective of the UK National Health Service.

Methods: An economic evaluation was conducted based on evidence from the double-blind, randomized, placebo-controlled GPRF [General Practice Research Framework] Nasal Steroids for Otitis Media with Effusion (GNOME) trial. Participants comprised 217 children aged 4-11 years who had at least one episode of otitis media or related ear problem in the previous 12 months and had tympanometrically confirmed bilateral OME.

Topical intranasal corticosteroids in 4-11 year old children with persistent bilateral otitis media with effusion in primary care: double blind randomised placebo controlled trial.

Objective: To determine the clinical effectiveness of topical intranasal corticosteroids in children with bilateral otitis media with effusion.

Design: Double blind randomised placebo controlled trial.

Setting: 76 Medical Research Council General Practice Research Framework practices throughout the United Kingdom, between 2004 and 2007.

Mapping analyses to estimate health utilities based on responses to the OM8-30 Otitis Media Questionnaire.

Purpose: To investigate the statistical relationship between the OM8-30 health-related quality of life measure for children with otitis media with effusion (OME) and measures of health utility (Health Utilities Index [HUI] Mark 3 and Mark 2) and to develop models to estimate HUI3 and HUI2 health utilities from OM8-30 scores.

Methods: A placebo-controlled, randomised trial (GNOME) evaluating intranasal mometasone in 217 children with OME provided concurrent responses to OM8-30 and HUI at three time points. Ordinary least squares (OLS), generalised linear models and two-step regression analyses were used to predict HUI3 and HUI2 utilities based on OM8-30 facet and domain scores.

Antibiotics and topical nasal steroid for treatment of acute maxillary sinusitis: a randomized controlled trial.

Context: Acute sinusitis is a common clinical problem that usually results in a prescription for antibiotics but the role of antibiotics is debated. Anti-inflammatory drugs such as topical steroids may be beneficial but are underresearched.

Objective: To determine the effectiveness of amoxicillin and topical budesonide in acute maxillary sinusitis.

Consultations for middle ear disease, antibiotic prescribing and risk factors for reattendance: a case-linked cohort study.

Background: Otitis media is the most common reason for children to receive antibiotics, but there is no evidence about the effect of prescribing on reattendance.

Aim: To evaluate the changing workload of middle ear disease in general practice, and the impact on surgery reattendance of prescribing antibiotics at first attendance.

Design Of Study: A case-linked cohort analysis for antibiotic prescribing versus no prescribing at first consultation event.