Symptom Score Helps Monitor Recovery from Ear Infections

A simple 13-point symptom score can help in tracking improvement in infants and toddlers with middle ear infection, or acute otitis media (AOM), reports a study in the January issue of the Pediatric Infectious Disease Journal. The journal is published by Lippincott Williams & Wilkins, a part of Wolters Kluwer Health.

Dr. Nader Shaikh and colleagues of Children's Hospital of Pittsburgh have authored two articles for the January issue. The first article discusses the development of their new AOM symptom severity scale, the "AOM-SOS," and the second reports on the validation of the system in children with AOM.

In developing their new AOM-SOS, the researchers first created a list of 28 symptoms associated with middle ear infection, with input from pediatric experts and parents. They then narrowed the list to the seven most important AOM symptoms: ear pain, ear tugging, irritability, decreased play, decreased appetite, difficulty sleeping, and fever. These seven symptoms were incorporated into the 13-point AOM-SOS score. To calculate the AOM-SOS, the first six symptoms were rated on a 0-to-2 scale (none = 0, a little = 1, a lot = 2). The final symptom, fever, was rated either absent (0) or present (1).

The researchers then evaluated how well the AOM-SOS reflected the presence and severity of AOM. The analysis was based on infants and toddlers who, as part of another study, underwent otoscopy (ear examination) at regular clinic visits during "respiratory season," from late fall to early spring.