Abstract
OBJECTIVE: To determine the interobserver reliability of tympanograms obtained with the MicroTymp, a portable tympanometer. SETTING: Family medicine teaching unit in a tertiary care hospital. PATIENTS: Thirty-three patients who presented to the ear, nose and throat clinic in August 1990 for an ear problem. INTERVENTION: Three residents in family medicine independently attempted to record with the MicroTymp one tympanogram for the 66 ears. We excluded the results for seven ears for which tympanograms could not be obtained. MAIN OUTCOME MEASURE: Using objective criteria, two family physicians and two residents in family medicine independently classified the 177 tympanograms into five categories (normal, possible effusion, possible perforation, possible tympano-ossicular dysfunction and unclassifiable). Reliability was estimated by means of the kappa (kappa) coefficient on 161 tympanograms from 59 ears for which the interpretation of the three tympanograms agreed. MAIN RESULTS: The interpretation of the three tympanograms agreed for 34 of the 59 ears (0.58) (kappa = 0.52, 95% confidence limits 0.45 and 0.59). There was no significant difference in interobserver reliability between pairs of observers or between symptomatic and asymptomatic ears. CONCLUSIONS: The interobserver reliability of the MicroTymp is moderate. The tympanograms obtained with the instrument should be interpreted in the context of the clinical findings.
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Selected References
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- Koran L. M. The reliability of clinical methods, data and judgments (first of two parts). N Engl J Med. 1975 Sep 25;293(13):642–646. doi: 10.1056/NEJM197509252931307. [DOI] [PubMed] [Google Scholar]
- Labrecque M., Dumont H. Gare à l'interprétation du tympanogramme. CMAJ. 1991 Jun 1;144(11):1386–1388. [PMC free article] [PubMed] [Google Scholar]
- Margolis R. H., Heller J. W. Screening tympanometry: criteria for medical referral. Audiology. 1987;26(4):197–208. doi: 10.3109/00206098709081549. [DOI] [PubMed] [Google Scholar]
- Paradise J. L., Smith C. G., Bluestone C. D. Tympanometric detection of middle ear effusion in infants and young children. Pediatrics. 1976 Aug;58(2):198–210. [PubMed] [Google Scholar]
- Tympanometry. ASHA Working Group on Aural Acoustic-Immittance Measurements Committee on Audiologic Evaluation. J Speech Hear Disord. 1988 Nov;53(4):354–377. [PubMed] [Google Scholar]
- Wazen J. J., Ferraro J. A., Hughes R. Clinical evaluation of a portable, cordless, hand-held middle ear analyzer. Otolaryngol Head Neck Surg. 1988 Sep;99(3):348–350. doi: 10.1177/019459988809900318. [DOI] [PubMed] [Google Scholar]
- de Melker R. A. Diagnostic value of microtympanometry in primary care. BMJ. 1992 Jan 11;304(6819):96–98. doi: 10.1136/bmj.304.6819.96. [DOI] [PMC free article] [PubMed] [Google Scholar]