<i>The Cochrane Library</i> and acute otitis media in children: an overview of reviews
Notice bibliographique
Résumé
Abstract Background This overview critically evaluates the available evidence The Cochrane Library offers on the treatment of acute otitis media (AOM). AOM is one of the most common clinical problems in childhood with peak incidence occurring in the first two years of life. Objectives To summarize Cochrane reviews that assess the effects of treatments for AOM in children. Methods The Cochrane Library was searched using the terms ‘otitis media’ and ‘ear infection’. Those reviews focusing on the treatment of AOM in children were included. Data on patient relevant outcomes (pain, treatment failure, AOM recurrence, and adverse events) were extracted by two authors. Main Results Five reviews were included in this overview. In the first review, antibiotics were compared with placebo. Although it appeared from the reports reviewed that antibiotics have marginal efficacy (number needed to treat = 12; number needed to harm = 12), because the reviewed studies included mostly older children with mild AOM, the results can not be generalized to young children or to children with severe AOM. In the second review, short (<7 days) and long courses of antibiotics were compared. Although the data were limited, shorter courses resulted in an increased likelihood of treatment failure [odds ratio (OR): 1.34, 95% confidence interval (CI): 1.16, 1.55]. In the third review, once‐daily administration of antibiotics was compared with two‐ or three‐times‐daily administration. Although no significant differences were noted, the quality of the original data on which the review was based was less than optimal. In the fourth review, decongestants and/or antihistamines were compared with placebo. Decongestants and antihistamines provided no appreciable benefit and were associated with significant adverse events (OR: 7.34, 95% CI: 1.67, 32.25). In the fifth review, topical analgesic drops and placebo were compared in two small studies. Use of analgesic drops was associated with significant reductions in pain level (OR: 3.07, 95% CI: 1.33, 7.05 for pain reduction of ≥ 50%). Authors' Conclusions Additional well‐designed trials in children of various age groups with AOM are needed to determine the efficacy of 1) standard‐course antibiotic treatment, 2) short‐course vs standard‐course antibiotic treatment, and 3) topical analgesia. Limited evidence suggests that the use of decongestants and/or antihistamines in children with AOM should be avoided. Copyright © 2009 The Cochrane Collaboration. Published by John Wiley & Sons, Ltd. The Cochrane Collaboration
Récupéré en direct depuis OpenAlex et désinversé. Les résumés ne sont pas conservés dans cette base de données : les index inversés représentent 8,6 Go des 9,3 Go de texte de la base, et le serveur dispose de 13 Go libres.
Comment cette classification a été obtenuedéplier
Prédiction machine sur la base complète
Imitation des enseignantsNi prévalence calibrée, ni vérité terrain. Validation humaine à venir. Le volet Gemma est une étiquette directe du modèle pour chaque travail de la base, lue sur la notice réduite au titre. Le volet Codex est un classifieur appris des 10 348 étiquettes directes de Codex et calibré sur les taux pondérés de l'échantillon; les champs sans appui suffisant ne portent aucun appel Codex. Le mode candidate est l'union des deux volets; le consensus est leur intersection. Ces sorties portent le statut machine_predicted_unvalidated et ne sont pas des étiquettes humaines.
Scores du classifieur distillé par catégorie (deux têtes)
| Catégorie | Codex | Gemma |
|---|---|---|
| Métarecherche | 0,007 | 0,035 |
| Méta-épidémiologie (sens strict) | 0,003 | 0,002 |
| Méta-épidémiologie (sens large) | 0,009 | 0,006 |
| Bibliométrie | 0,021 | 0,025 |
| Études des sciences et des technologies | 0,001 | 0,001 |
| Communication savante | 0,006 | 0,004 |
| Science ouverte | 0,002 | 0,002 |
| Intégrité de la recherche | 0,003 | 0,002 |
| Charge utile insuffisante (le modèle a refusé de juger) | 0,012 | 0,001 |
Scores machine (provisoires)
Les deux têtes enseignantes du modèle étudiant, lues sur ce travail. Un score ordonne la base pour la relecture; il n'affirme jamais une catégorie, et le statut de validation accompagne chaque rangée tel quel.
Scores de référence d'un modèle non mature (critères de maturité non atteints, 7 itérations). Un score ordonne; il n'affirme jamais une catégorie.
score_only:v0-immature-baseline · tel quel depuis la passe de notation : score_only signifie que le nombre peut ordonner les travaux, et qu'aucune étiquette de catégorie n'en découleClassification
machine, non validéePrédiction automatique; un appel candidat d’une seule source (Gemma direct ou Codex distillé), pas un consensus.
Le détail, modèle par modèle et score par score, se trouve en fin de page sous « Comment cette classification a été obtenue ».