Otitis Media Meta-analysis

To the Editor.—

The results of the meta-analysis by Roberts et al¹ suggested no to very small negative associations of otitis media with effusion (OME) and associated hearing loss to children’s later speech and language development. This conclusion is in accordance with the available evidence; ie, most studies performed thus far indeed have not shown a clear association. The methods used in the meta-analysis, however, are incorrect, and the readers of Pediatrics should be aware of this.

First, the authors pooled the data of 3 randomized, controlled trials and 4 observational studies. All randomized, controlled trials included in the meta-analysis studied the effect of treatment with ventilation tubes on speech and language in children with persistent OM, whereas the observational studies investigated the effect of OM on the speech and language development in open populations. In the meta-analysis, Roberts et al classified the group with the least OM as “OM−” and the one with the most OM as “OM+”; ie, the children with persistent OME treated with …