Ref (type)	Population	Outcome, Interventions	Results and statistical analysis	Effect size	Favours
Adverse effects
RCT	100 people in secondary care with ear wax preventing inspection of the tympanic membrane	Median pain score on a 100 mm visual analogue scale from 0 (no pain) to 100 (very painful) 5 with endoscopic vision 25 with microscopic vision	P = 0.002 Possible bias; for full details see Further information on studies	Effect size not calculated	endoscopy
RCT	100 people in secondary care with ear wax preventing inspection of the tympanic membrane	Median discomfort score on a 100 mm visual analogue scale from 0 (no discomfort) to 100 (very uncomfortable) 3.5 with endoscopic vision 10 with microscopic vision	P = 0.075 Possible bias; for full details see Further information on studies		Not significant
RCT	100 people in secondary care with ear wax preventing inspection of the tympanic membrane	Traumatisation to the skin of the canal causing a minor bleed 1/50 (2%) with endoscopic vision 1/50 (2%) with microscopic vision	Possible bias; for full details see Further information on studies