ESSAY: Analysis of Current Evidence Based Practice Guidelines for the Treatment of OM

This Assignment requires a current, evidence based practice guideline that is specific to the child in the following scenario. Once you find the appropriate guideline, you will be ready for analysis and evaluation.
• First, carefully review the case.
• Then, using the online National Guideline Clearinghouse data-base find current (no older than 4 years old) relevant evidence based practice guideline for the treatment of otitis media for this particular pediatric patient.
• There should be a minimum of three current (within the last 5 years) peer-reviewed references including the authors of the guideline.

Make sure to address the following in your paper:
• Briefly explain your search strategy. For example,
o How did you find the correct guideline?
• Who developed the guideline?
• Is this a revision of a previous guideline or an original?
• What is the date of publication?
• Explain the concept of “systematic review of current best evidence.”
• How was conflict of interest managed in the development of these guidelines?
• How is quality of evidence defined?
• Explain differences among strong recommendation, recommendation, and option
• What are “key Action statements?”
• For this particular child,
o What are the specific treatment recommendations including:
 Any diagnostics,
 Medications (include exact dosage, frequency, length of treatment),
 Follow-up,
 Referral,
 Prevention, and
 Pain control

Case:
A 5-year-old male is brought to the primary care clinic by his mother with a chief complaint of bilateral ear pain for the last three days. The mother states that the child has been crying frequently due to the pain. Ibuprofen has provided minimal relief. This morning, the child refused breakfast and appeared to be “getting worse.”
Vital signs at the clinic reveal HR 110 bpm, 28 respiratory rate, and tympanic temperature of 103.2 degrees F. The mother reports no known allergies. The child has not been on antibiotics for the last year. The child does not have history of OM. The child is otherwise healthy without any other known health problems.
After your questioning and examination, you diagnose this child with bilateral Acute Otitis Media.

ANSWER

Evidence-Based Practice Guidelines for the Treatment of OM

Introduction

Otitis Media refers to inflammation disease of the central ear. Two types of this disorder include; acute otitis media (AOM) and otitis media with effusion (OME). Acute otitis media, which was diagnosed in the scenario provided refers to abrupt onset that presents ear pain. It is characterized by the existence of noncontagious liquid in the ear (Qureishi, Lee, Belfield, Birchall & Daniel, 2014).

Evidence-Based Clinical Guideline 2013

The above verified procedure was adopted in 2013 as an amendment of the 2004 Acute Otitis Media (AOM) guideline that was prepared by the American Academy of Pediatrics (AAP) and the American Academy of Family Physicians. This procedure gives recommendation for the management of patient aged half a year to 12 years. In our case scenario, the child is within this bracket (5 years) hence this guideline is the best fit for his or her treatment. The guideline applies to healthy children who do not have underlying conditions that may change the functioning of otitis media (Allan, Carroll & Chonmaitree, 2013). The guideline was published by American Academy of Pediatrics in 2013. The guideline was chosen based on the superiority of evidence as well as the analysis of gain- mischief relationship. The guideline was also subjected to peer review before the AAP finally approved it. This ensured that the relevant authority reviewed the recommendations thereby promoting its quality, reliability, and extensively reviewed the recommendations.

Systematic Review of Current Based Evidence

            A systematic review of current best evidence is a logical method to gather the available current data from research readings. The review is mainly about a medical topic that is designed to be a source of information to guide clinicians in their decision-making process (Ito et al., 2014). In a systematic review, the researchers present an extensive and reputable plan of the literature reviewed to evaluate of the evidence. The evidence is then categorized as likely to be useful, likely to be dangerous or does not support either benefit or harm.

Quality of Evidence and Management of Conflicts             The superiority of evidence defines the degree to which assurance in an assessment of the outcome is satisfactory to hold up a particular suggestion. This requires comparison of the value of proof in relation to the situation where the proof is being used and formulating a different definition (Kitamura et al., 2015). Various factors reduce the quality of evidence, while others increase its quality. Factors that may reduce quality include; discrepancy of results, obliqueness of proof, vagueness, publication prejudice while those that amplify quality include dose-response gradient, plausible confounding and large magnitude…