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Table 4

Summary of included review articles

AuthorsPeer reviewed?OM definedResultsCommentsQuality?
Bronfort et al37Yes“…middle ear inflammation which can exist in an acute or chronic state and can occur with or without symptoms.”“Inconclusive evidence in an unclear direction regarding the effectiveness of OMT for OM.”Reviewed the following review articles: Hawk et al, Ernst et al, and Goltib et al; RCTs: Mills et al and Wahl et alExcellent
Cole and Reed38YesNA“Limited data show that OMT may also be effective for non-spinal disorders.”Reviewed Mills et alGood
Ferrance and Miller39YesAOM—“characterized by an abrupt onset of local signs such as ear pain or pressure, and systemic signs such as malaise or fever.”“…there really is no credible solid evidence upon which to make recommendations regarding the use of chiropractic care in the treatment of acute OM.”Stated that there was little evidence beyond case series, case reports, and 1 RCT (Mills et al) to support manipulative care for OMGood
Alcantara et al40YesNA“…emphasized clinical management strategies in the care of children with OM.”Abstract only. Reviewed 19 articlesFair
Leighton41YesRecurrent chronic OM“The evidence is inconclusive.… There is insufficient evidence to predict long-term outcomes.”Reviewed the following case series: Fysh, Fallon, & Froehle; RCTs: Sawyer et al, Wahl et al, & Mills et al; mentioned numerous case reviewsFair
Hawk et al42YesDid not explicitly define“Evidence was promising for the potential benefit.…”Reviewed the following RCTs: Mills et al & Sawyer et al; Case series: Fallon, Froehle, & Fysh; case reports: Peet, Phillips, & ThomasExcellent
Carr and Nahata43YesUpper respiratory tract infection“…may decrease the frequency of episodes of acute OM in children.…”Reviewed Sawyer et al RCTFair
Ernst44YesNA“…the notion that chiropractic manipulation is an effective treatment of non-spinal pain syndromes is not based on conclusive evidence.”Reviewed Sawyer et al RCTGood
AOM, Acute otitis media; NA, not applicable; OM, otitis media; OMT, osteopathic manipulative therapy; RCT, randomized control trial.