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Critical Appraisal Validity

This study investigates the effectiveness of two treatments for earwax removal: water drops (intervention group) and oil (control group). Patients were randomized into two groups based on even or odd birth years, raising concerns about the robustness of randomization methods. The analysis, although lacking explicit intention-to-treat reporting, showed no participant dropouts. Key findings indicate no significant baseline differences between groups, and with widely accessible water treatment viewed as practical, the results suggest both methods are safe, though preferences may vary among patients.

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Critical Appraisal Validity

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  1. Critical AppraisalValidity Validity

  2. Validity • Was it Randomized? Was randomization concealed? • The patients were randomised into an intervention group (n = 22, year ofbirth 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

  3. Validity • Was the data analyzed on an intention to treat basis? • None was mentioned but no participant backed out during the study.

  4. Was there adequate blinding of subjects and researchers? • “Randomising patients by year of birth (odd or even) is probably not the most robust method because operators could have known in advance in which group a patient would be randomised.” • “Nevertheless, the operators did not know in advance in which of the 130 patients the earwax was still persistent after the first five attempts at syringing”

  5. Validity • Were there similar baseline characteristics in each group? • All had 5 attempts of syringing with >75% obstruction. • Also, those with tympanic membrane perforation, middle ear operation, otitisexterna, swam within the previous 72 hours or have used ceruminolyticss within the previous 72 hours were not included.

  6. Applicability

  7. Applicability • Are any differences between patients and those studied different enough that you would not apply these results? • No, but there may be difference between the ear hygiene practices of the patients in the community and those in the study such as cotton bud usage etc.

  8. Applicability • Is treatment feasible? • Yes, water is very accessible and not costly. It will be more practical than spending for oil. • Patient Preference • Will depend on patient which method they prefer

  9. Applicability • Benefits vs. harm • Syringing may not be the preferred method of otolaryngologist but this is the most commonly used in general practice. The study has also shown that it is generally safe to apply. None of the participants had any complaints from syringing.

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