According to new study, researchers conducted a randomized crossover trial to compare the diagnostic accuracy of residents who used a smartphone otoscope attachment. Emergency department residents can diagnose acute otitis media in children as accurately using a smartphone otoscope attachment as they can with a traditional otoscope.
Participants were a convenience sample of 94 children between the ages of 1 to 5 years who presented with fever and respiratory symptoms to a single pediatric emergency department in a tertiary care hospital between 2015 and 2016. A total of 10 pediatric otolaryngologists first examined and cleaned each ear.
They diagnosed acute otitis media in 46/188 ears (25%). Children were them examined by two residents who were randomized to use the smartphone otoscope or a traditional otoscope. Participating physicians were residents completing a one-month rotation in pediatric emergency medicine.
A total of 90 residents evaluated at least one patient. Most residents were in their first- or second-year of rotation, and nearly all (96%) were frequent users of smartphones. This study is compared both the CellScope Oto and the traditional otoscope to the gold standard of binocular microscopy.
Diagnostic accuracies were 0.69 for residents using a traditional otoscope and 0.74 for those using the CellScope Oto. “Our study is the first to evaluate a new technology to facilitate ear exams,” said Dr. Gravel, noting that the CellScope Oto captured clear video images.
“These can be documented in medical charts and used to improve the teaching of residents,” she told Reuters Health by email. David H. Jung of Massachusetts Eye and Ear Infirmary in Boston, who was not involved in the study, said the work is important. “This research evaluates in a relatively unbiased way a new technology that could be used in children to examine ears and help diagnose acute otitis media,” Dr. Jung told Reuters Health by email.
Because acute otitis media is one of the most frequent reasons for emergency department visits, “Any improvement in its diagnosis would potentially have a large clinical impact,” he said. He also pointed out that the new device cannot clean cerumen from ears like a traditional otoscope.
On the other hand, it provides the opportunity to enter a visual record of the exam in the patient’s medical record in a way that the traditional otoscope does not. Dr. Emory Petrack, chief of Pediatric Emergency Medicine at Floating Hospital for Children at Tufts Medical Center, also in Boston, said physicians are always looking for practical and useful tools to improve their diagnostic skill.
Author concludes that While the smartphone otoscope is not clinically superior, this study supports its use. The most important benefits are likely to come from digital images used for teaching, documentation and telemedicine.