THE EFFECTIVENESS OF VIDEO DISCHARGE INSTRUCTIONS FOR ACUTE OTITIS MEDIA IN CHILDREN: A RANDOMIZED CONTROLLED TRIAL
Bibliographic record
Abstract
Abstract BACKGROUND Pain, the most identifiable feature of acute otitis media (AOM), is undertreated with 30% of children ≤ 2 years experiencing pain, fever, or both for up to 7 days, highlighting the importance of effective caregiver education. OBJECTIVES We sought to determine if video discharge instructions were associated with improved symptomatology, functional outcomes, and knowledge compared to a paper handout. DESIGN/METHODS We conducted a randomized controlled superiority trial comparing video discharge instructions (Easy Sketch Pro3TM) on management of pain and fever to a paper handout detailing the same. We included primary caregivers of children 6 months to 5 years presenting to the emergency department (ED) with a clinical diagnosis of AOM. The primary outcome was symptomatology using the Acute Otitis Media Severity of Symptom (AOM SOS) score between 48 and 72 hours. The 7-item self-report AOM-SOS is scored from 0 to 13 with a higher score indicating more symptomatology. Secondary outcomes included knowledge gain using a 10-item survey, days of daycare/school/work missed, and recidivism. RESULTS A total of 219 caregivers were randomized and 149 completed the 72-hour follow-up (72 paper and 77 video). Participants were primarily mothers (175/219, 79.9%); 136/219 (62.1%) completed post-secondary education and 147/219 (67.1%) had previously cared for a child with AOM. Children included 107/219 (48.6%) females with an overall mean (SD) age of 2.9 (2.8) years. Caregivers did not offer analgesia to 41/219 (18.7%) of children. The median (IQR) AOM-SOS score in the video group was significantly lower than the paper group, even after adjusting for pre-intervention AOM-SOS and medication (analgesics and antibiotics) given by caregivers [8 (7,11) versus 10 (7,13), respectively, p = 0.004]. There were no significant differences between video and paper in the mean (SD) number of correct answers given on the post-intervention survey [9.2 (1.3) versus 8.8 (1.8), respectively, p = 0.07], mean (SD) number of children that returned to a health provider [8/77 versus 10/72, respectively, p = 0.49), mean (SD) number of daycare/school missed by child [1.2 (1.5) versus 1.1 (2.1), respectively, p = 0.62, mean (SD) number of work missed by caregiver [0.5 (1) versus 0.8 (2), respectively, p = 0.05]. CONCLUSION Children of caregivers with AOM who received a five-minute video detailing the identification and management of pain and fever experienced less symptomatology compared to a paper handout. Our findings suggest that video discharge instructions in the ED are effective for caregiver education and should be used routinely.
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How this classification was reachedexpand
Full frame distilled prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.
Codex and Gemma teacher scores by category
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.010 | 0.004 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.002 | 0.001 |
| Bibliometrics | 0.000 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.000 | 0.001 |
| Insufficient payload (model declined to judge) | 0.000 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one teacher head, not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".