Given the prognostic power of the set of variables included in their selection strategy, it is not surprising that a very limited number of additional potential prognostic factors contributed to prognosis. The identification of these additional factors is the evidence-based contribution of their study. Recurrent URIs, and in their absence intact adenoids, summer-fall presentation, and a history of otitis during the first year of life all marginally increase the likelihood of persistent effusion, although the discriminant power of these factors is low. However, these items and the inclusion criteria may be important and possibly discriminating factors in the general population of children visiting family physicians and pediatricians.
Future research
What remains for future investigation is the evaluation of the discriminating capacity and screening characteristics—both sensitivity and specificity—of each of the identification factors when applied to general primary care populations. For now, the most important take-home message might be that the inclusion criteria coupled with URI at follow-up are highly predictive of persistent OME and deserving of further patient follow-up and a hearing evaluation.