Defining the Terminology for Acute Ear Discharge in Children: Systematic Review and Expert Consensus Using the Nominal Group Technique

Background Acute otitis media (AOM) is one of the most frequent paediatric infections. In approximately 15% of children with AOM, the tympanic membrane perforates, leading to ear discharge. This subset of children is usually more unwell and may need different treatment than those without a perforation. Therefore, terminology is required to differentiate this population from AOM without perforation. Using a consensus exercise, we aimed to standardise disease terminology for this patient group. Methods A systematic review was performed using OVID Embase to identify the terminology used within the current published literature. The RAND version of the Nominal Group Technique was then used to gain consensus using an expert panel. Results The systematic review identified 2012 abstracts which were reviewed, of which 29 manuscripts were included. A total of nine different definitions were identified within the literature. The expert panel concluded that the terminology ‘acute otitis media with discharge (AOMd)’ should be used when diagnosing a child with an acutely discharging ear of up to 6 weeks duration. Recurrent disease should be diagnosed when four or greater episodes occur per year. Within this disease context, the panel determined the optimal research question was to identify the best management option. Conclusion This consensus process has proposed the terminology that should be applied for children with acute ear discharge secondary to AOM. The use of standardised terminology is essential to improve patient care and ensure homogeneity across future research.