Pichichero Michael E, Poole Michael D
Elmwood Pediatric Group, University of Rochester Medical Center, 601 Elmwood Avenue, Box 672, Rochester, NY 14642, USA.
Int J Pediatr Otorhinolaryngol. 2005 Mar;69(3):361-6. doi: 10.1016/j.ijporl.2004.10.013. Epub 2004 Dec 21.
To compare the performance of United States, South African, and Greek otolaryngologists, pediatricians, and general practitioners in recognizing the otoscopic examination findings of acute otitis media (AOM) and otitis media with effusion (OME) as presented in an otoendoscopic video evaluation test.
DESIGN/SUBJECTS: Otolaryngologists, pediatricians, and general practitioners from the United States (n = 273, 2190, and 360 respectively), South Africa (n = 36, 36, and 206), and Greece (n = 58, 115, and 126) viewed nine different video-recorded otoscopic examinations, including pneumatic otoscopy of tympanic membranes. The ability to differentiate AOM, OME, and normal was ascertained.
Overall, the average +/- standard deviation correct diagnosis on the otoscopic video exam by otolaryngologists was superior to pediatricians and general practitioners in all three countries: from the United States, it was 74 +/- 16% for otolaryngologists versus 51 +/- 11% for pediatricians (p < 0.000l) and 46+/-21% for general practitioners (p < 0.0001); from South Africa, it was 72 +/- 16% versus 53 +/- 21% (p = 0.16) and 47 +/- 19% (p = 0.002); and from Greece, it was 61 +/- 15% versus 36 +/- 12% (p < 0.003) and 39 +/- 10% (p = 0.009).
A video-based otoscopy examination test may be a useful tool for evaluation of otoscopy-based diagnostic skills. Otolaryngologists performed significantly better than pediatricians in differentiating AOM, OME, and normal in such a test described here. However, all specialists who examine patients with AOM or OME may benefit from viewing video otoscopies to improve diagnostic accuracy.
在一项耳内镜视频评估测试中，比较美国、南非和希腊的耳鼻喉科医生、儿科医生和全科医生识别急性中耳炎（AOM）和中耳积液（OME）耳镜检查结果的能力。
设计/研究对象：来自美国（分别为273名、2190名和360名）、南非（分别为36名、36名和206名）和希腊（分别为58名、115名和126名）的耳鼻喉科医生、儿科医生和全科医生观看了9段不同的耳镜检查视频记录，包括鼓膜的气耳镜检查。确定区分AOM、OME和正常情况的能力。
总体而言，在所有三个国家，耳鼻喉科医生在耳镜视频检查中的平均±标准差正确诊断率均优于儿科医生和全科医生：在美国，耳鼻喉科医生为74±16%，儿科医生为51±11%（p<0.0001），全科医生为46±21%（p<0.0001）；在南非，分别为72±16%、53±21%（p = 0.16）和47±19%（p = 0.002）；在希腊，分别为61±15%、36±12%（p<0.003）和39±10%（p = 0.009）。
基于视频的耳镜检查测试可能是评估基于耳镜的诊断技能的有用工具。在此处描述的此类测试中，耳鼻喉科医生在区分AOM、OME和正常情况方面的表现明显优于儿科医生。然而，所有检查AOM或OME患者的专科医生都可能从观看视频耳镜检查中受益，以提高诊断准确性。
