Classification of otitis media

OBJECTIVES: To review the International Classification of Diseases (ICD) system of classifying otitis media. To highlight the failings of this system and to propose an alternative (Read version 3). STUDY DESIGN: An historical review of the literature and a presentation of two distinct classification schemes. METHODS: The advantages and disadvantages of the alternative schemes are analyzed and an algorithm for the classification of otitis media is presented that describes the decisions taken to reach a diagnosis. RESULTS: The proposed classification of otitis media as used in the Read Codes thesaurus is more logical than the ICD classification. CONCLUSIONS: The widely used ICD schema of otitis media fails to provide the otologist or general medical practitioner with a logically organized set of terms to describe inflammatory middle ear disease. This article proposes a simple, hierarchical classification that can be used by specialists, generalists and epidemiologists alike.