Outcomes research assesses the end results of health care from the perspective of those who receive the care, those who provide it, and those who pay for it. The article by Karin Minter and her colleagues¹ at the Frank Porter Graham Child Development Center in Chapel Hill, North Carolina, provides important new information related to the functional outcomes of otitis media (OM) in early childhood. Their study documenting the relationship of otitis media with effusion (OME) and hearing loss with functional measures of attention and behavior obtained from parents, teachers, and clinicians appears in this issue of Pediatrics.¹ They conducted this prospective cohort study in 85 children whose middle ear and hearing status had been closely monitored from 6 months to 4 years of age. The diagnosis of OME was based on both pneumatic otoscopy and tympanometry. Audiologists who were unaware of the middle ear findings performed hearing assessments. The validated measures used to assess outcomes included the behavior rating scale of the Bayley Scales of Infant Development, the Parenting Stress Index, the Social Skills rating system, and the Conners' Teacher/Parent Rating Scale. Children's attention and behavior were assessed during infancy, preschool, and first grade. Mother's education, socioeconomic status, child gender, child care quality, and a measure of the home environment (home screening questionnaire) were included as covariates in all analyses. When these covariates were considered, there were no significant correlations between OME or hearing loss with any of the measures of attention and behavior at any age during the first 6 years of life.

In a previous publication, the investigators failed to document an association between otitis or hearing loss and the acquisition of language skills in this population.² The availability of this new data as well as the recent publication of several prospective cohort studies and a randomized clinical trial of ventilating . . . [Full Text of this Article]