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Dates: 2004-2009
Funding: NIHR Health Technology Assessment programme (HTA)
Collaborators: Dr Stavros Petrou, University of Warwick. Dr. Ian Williamson and Dr. Sarah Benge, University of Southampton
Information: Helen Dakin

Otitis media with effusion is a common condition in childhood, and in its chronic and recurrent forms a source of substantial NHS costs, with over £200 million per year spent on related prescribing. The majority of children are referred on from primary care, but confusions over treatment and uncertain diagnosis have historically contributed to a broad and at times inequitable gateway to secondary services.  GNOME is a randomised controlled placebo-controlled trial evaluating topical intra-nasal steroids in 4-11 year old children with persistent bilateral otitis media with effusion, in primary care. HERC estimated the cost-effectiveness of the treatment over the nine month follow-up period of the trial. The application of multi-attribute utility measures within the trial has also allowed us to address important methodological issues around utility measurement in childhood, such as mapping between the disease-specific OM8-30 questionnaire and multi-attribute utility measures.

The results of the GNOME study have been published as a Health Technology Assessment report. In addition, the results of the economic evaluation have been published in Value in Health, clinical results have been published in the British Medical Journal and a separate study that maps between the OM8-30 health related quality of life measure and HUI has been published in Quality of Life Research.


Petrou S, Dakin H, Abangma G, Benge S, Williamson, I (2010). Cost-utility analysis of topical intranasal steroids for otitis media with effusion based on evidence from the GNOME trial. Value Health, 13, 543 - 551

Dakin, H, Petrou, S, Haggard, M, Benge, S, and Williamson, I (2010). Mapping analyses to estimate health utilities based on responses to the OM8-30 Otitis Media Questionnaire. Qual Life Res, 19(1):65-80.

Williamson, I, Benge, S, Barton, S, Petrou, S, Letley, L, Fasey, N, Haggard, M, and Little, P. 2009. Topical intranasal corticosteroids in 4-11 year old children with persistent bilateral otitis media with effusion in primary care: a double blind randomised placebo controlled trial. British Medical Journal; 339:b4984, doi: 10.1136/bmj.b4984

Williamson, I, Benge, S, Petrou, S, Letley, L, Fasey, N, Abangma, G, Dakin, H, and Little, P. 2009. A double-blind randomised placebo controlled trial of topical intra-nasal corticosteroids in 4-11 year old children with persistent bilateral Otitis Media with Effusion in primary care Health Technology Assessment. 13(37):1-144.