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JOURNAL APPRAISAL. Que , Mary Harmony Rivera, Joanna Grace Sioco , Demetrio Roberto. Clinical SITUATION. Increasing number of children in the community with impacted cerumen Finding cost-effective means of addressing this problem. Research Question.

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journal appraisal

JOURNAL APPRAISAL

Que, Mary Harmony

Rivera, Joanna Grace

Sioco, Demetrio Roberto

clinical situation
Clinical SITUATION
  • Increasing number of children in the community with impacted cerumen
  • Finding cost-effective means of addressing this problem
research question
ResearchQuestion

Among children with impacted cerumen, is the application of water as a softening agent effective in clearing the ear canal (using a randomized control trial)?

slide4

A quasi-randomised controlled trialof water as a quick softening agent of persistent earwax in general practice

A Journal Article on Therapeutics

method
METHOD
  • Population:
    • Patients with persistent earwax (more than 75% obstruction after 5 attempts of syringing)
    • Intervention group: 22 patients
    • Control group: 20 patients
method1
METHOD
  • Water (room temp) dropped at affected ear until ear is full and canal covered with a wad of cotton
  • left for 15 minutes in the waiting area of an actual patient encounter
  • Irrigation with 100cc syringe
  • Olive oil dropped on affected ear until ear is full and covered with a wad of cotton
  • Done every night for 3 days before patient encounter
  • Irrigation with 100cc syringe

Intervention -water

Control -mineral oil

validity
Validity
  • Was it Randomized? Was randomization concealed?
    • The patients were randomised into an intervention group (n = 22, year of birth was even) and control group (n = 20, year of birth was odd).
    • Intervention Group – drops of water for 15mins.
    • Control Group – oil at night for 3 days
results of the study
Results of the Study
  • Intervention group: 3.0 ((95% CI = 2.4 to 3.6)
  • Control group: 2.4 (95% CI = 1.7 to 3.1).
  • The difference between these means (0.6; 95% CI = -0.3 to 1.5)
  • P value: 0.18 (not statistically significant)
applicability
Applicability
  • Water can be an alternative softener for impacted cerumen.
  • Water is very accessible and not costly(can be more practical than spending for oil)
  • Though syryinging is not the most preferable method by otolaryngologist, the practice can be considered generally safe to apply