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. 2023 Sep 26;2023(9):CD015253. doi: 10.1002/14651858.CD015253.pub2

Comparison 1. Autoinflation versus watchful waiting/no treatment.

Outcome or subgroup title No. of studies No. of participants Statistical method Effect size
1.1 Proportion of children whose hearing is normal (very short‐term, < 6 weeks) 1   Risk Ratio (M‐H, Random, 95% CI) Subtotals only
1.2 Proportion of children whose hearing is normal (short‐term, > 6 weeks to ≤ 3 months) 1 94 Risk Ratio (M‐H, Random, 95% CI) 2.67 [1.73, 4.12]
1.3 Hearing threshold (very short‐term, < 6 weeks) 1 45 Mean Difference (IV, Random, 95% CI) ‐5.00 [‐10.10, 0.10]
1.4 Hearing threshold (short‐term, > 6 weeks to ≤ 3 months) 2   Mean Difference (IV, Random, 95% CI) Subtotals only
1.4.1 0.5 kHz 2 113 Mean Difference (IV, Random, 95% CI) ‐9.13 [‐15.14, ‐3.13]
1.4.2 1.0 kHz 2 113 Mean Difference (IV, Random, 95% CI) ‐10.34 [‐17.85, ‐2.83]
1.4.3 2.0 kHz 2 113 Mean Difference (IV, Random, 95% CI) ‐9.04 [‐14.84, ‐3.25]
1.4.4 4.0 kHz 2 113 Mean Difference (IV, Random, 95% CI) ‐12.88 [‐17.01, ‐8.75]
1.5 Disease‐specific quality of life (short‐term, > 6 weeks to ≤ 3 months) 1 247 Mean Difference (IV, Random, 95% CI) ‐0.42 [‐0.62, ‐0.22]
1.6 Adverse events ‐ pain and distress caused by the procedure (otalgia) 1   Risk Ratio (M‐H, Random, 95% CI) Subtotals only
1.6.1 Otalgia 1 320 Risk Ratio (M‐H, Random, 95% CI) 3.50 [0.74, 16.59]
1.7 Persistence of OME (very short‐term, < 6 weeks) 7 688 Risk Ratio (M‐H, Random, 95% CI) 0.86 [0.72, 1.04]
1.7.1 Per ear data 6 670 Risk Ratio (M‐H, Random, 95% CI) 0.85 [0.69, 1.04]
1.7.2 Per child data 1 18 Risk Ratio (M‐H, Random, 95% CI) 1.00 [0.72, 1.39]
1.8 Persistence of OME (short‐term, > 6 weeks to ≤ 3 months) 4 483 Risk Ratio (M‐H, Random, 95% CI) 0.88 [0.80, 0.97]
1.8.1 Per ear data 3 466 Risk Ratio (M‐H, Random, 95% CI) 0.87 [0.79, 0.96]
1.8.2 Per child data 1 17 Risk Ratio (M‐H, Random, 95% CI) 1.12 [0.61, 2.07]
1.9 Episodes of acute otitis media (short‐term, > 6 weeks to ≤ 3 months) 2 403 Risk Ratio (M‐H, Random, 95% CI) 0.82 [0.49, 1.36]
1.10 Sensitivity analysis: Proportion of children whose hearing is normal (very short‐term, < 6 weeks). Per ear data (ICC of 1, complete correlation between ears) 1   Risk Ratio (M‐H, Random, 95% CI) Subtotals only
1.11 Sensitivity analysis: Proportion of children whose hearing is normal (very short‐term, < 6 weeks). Per ear data (ICC of 0, no correlation between ears) 1   Risk Ratio (M‐H, Random, 95% CI) Subtotals only
1.12 Sensitivity analysis: Hearing threshold (short‐term, > 6 weeks to ≤ 3 months). Right ear data 2   Mean Difference (IV, Random, 95% CI) Subtotals only
1.12.1 0.5 kHz 2 117 Mean Difference (IV, Random, 95% CI) ‐9.13 [‐15.35, ‐2.92]
1.12.2 1.0 kHz 2 117 Mean Difference (IV, Random, 95% CI) ‐10.91 [‐20.07, ‐1.76]
1.12.3 2.0 kHz 2 117 Mean Difference (IV, Random, 95% CI) ‐9.59 [‐17.74, ‐1.44]
1.12.4 4.0 kHz 2 117 Mean Difference (IV, Random, 95% CI) ‐13.37 [‐20.66, ‐6.08]
1.13 Sensitivity analysis: Hearing threshold (short‐term, > 6 weeks to ≤ 3 months). Left ear data 2   Mean Difference (IV, Random, 95% CI) Subtotals only
1.13.1 0.5 kHz 2 115 Mean Difference (IV, Random, 95% CI) ‐8.97 [‐14.88, ‐3.06]
1.13.2 1.0 kHz 2 115 Mean Difference (IV, Random, 95% CI) ‐9.64 [‐15.50, ‐3.78]
1.13.3 2.0 kHz 2 115 Mean Difference (IV, Random, 95% CI) ‐8.06 [‐12.16, ‐3.97]
1.13.4 4.0 kHz 2 115 Mean Difference (IV, Random, 95% CI) ‐10.92 [‐15.42, ‐6.41]
1.14 Sensitivity analysis: Persistence of OME (very short‐term, < 6 weeks). Per ear data (ICC of 0) 6 862 Risk Ratio (M‐H, Random, 95% CI) 0.84 [0.68, 1.04]
1.15 Sensitivity analysis: Persistence of OME (very short‐term, < 6 weeks). Per ear data (ICC of 1) 6 551 Risk Ratio (M‐H, Random, 95% CI) 0.85 [0.70, 1.03]
1.16 Sensitivity analysis: Persistence of OME (very short‐term, < 6 weeks). Per child data, where available 7 621 Risk Ratio (M‐H, Random, 95% CI) 0.84 [0.68, 1.04]
1.16.1 Per ear data, adjusted for correlation for those with bilateral disease 4 300 Risk Ratio (M‐H, Random, 95% CI) 0.79 [0.55, 1.12]
1.16.2 Per child data: persistence in any affected ear 1 40 Risk Ratio (M‐H, Random, 95% CI) 1.05 [0.88, 1.25]
1.16.3 Per child data: persistence in all affected ears 2 281 Risk Ratio (M‐H, Random, 95% CI) 0.82 [0.68, 1.00]
1.17 Sensitivity analysis: Persistence of OME (short‐term, > 6 weeks to ≤ 3 months). Per ear data (ICC of 0) 4 617 Risk Ratio (M‐H, Random, 95% CI) 0.89 [0.82, 0.97]
1.17.1 Per ear data 3 600 Risk Ratio (M‐H, Random, 95% CI) 0.89 [0.82, 0.97]
1.17.2 Per child data 1 17 Risk Ratio (M‐H, Random, 95% CI) 1.12 [0.61, 2.07]
1.18 Sensitivity analysis: Persistence of OME (short‐term, > 6 weeks to ≤ 3 months). Per ear data (ICC of 1) 4 402 Risk Ratio (M‐H, Random, 95% CI) 0.90 [0.81, 1.00]
1.18.1 Per ear data 3 385 Risk Ratio (M‐H, Random, 95% CI) 0.90 [0.80, 1.00]
1.18.2 Per child data 1 17 Risk Ratio (M‐H, Random, 95% CI) 1.12 [0.61, 2.07]
1.19 Sensitivity analysis: Persistence of OME (short‐term, > 6 weeks to ≤ 3 months). Per child data, where available 4 441 Risk Ratio (M‐H, Random, 95% CI) 0.86 [0.78, 0.96]
1.19.1 Per ear data 2 179 Risk Ratio (M‐H, Random, 95% CI) 0.85 [0.68, 1.06]
1.19.2 Per child data 2 262 Risk Ratio (M‐H, Random, 95% CI) 0.82 [0.66, 1.02]