Damery L, Lescanne E, Reffet K, Aussedat C, Bakhos D
Faculté de médecine de Tours, université François-Rabelais de Tours, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours, France.
Faculté de médecine de Tours, université François-Rabelais de Tours, CHRU de Tours, 2, boulevard Tonnellé, 37044 Tours, France; Service ORL et chirurgie cervico-faciale, CHRU de Tours, boulevard Tonnellé, 37044 Tours, France.
Eur Ann Otorhinolaryngol Head Neck Dis. 2019 Feb;136(1):13-17. doi: 10.1016/j.anorl.2018.10.016. Epub 2018 Nov 2.
General practitioners (GPs) play an essential role in the management of ear disease, but their diagnosis of pathologic eardrums is inadequate. The aim of this study was to compare the quality of otoscopic diagnosis by GPs using a conventional otoscope versus a video-otoscope. Subjects and method Eleven GPs included 124 patients with ear complaints (193 otoscopies). Examination successively used conventional otoscopy and video-otoscopy. After each type of examination, a 10-criterion assessment questionnaire was filled out and a diagnosis was proposed. Two blinded ENT specialists reviewed the video-otoscopy images and filled out the same grid questionnaire to make their diagnosis. GPs also completed a Likert-scale satisfaction questionnaire on video-otoscopy.
There were no significant differences in overall examination results between the three groups (GP conventional otoscopy, GP video-otoscopy and ENT specialist). However, focusing exclusively on pathologic eardrums, there was a significant difference in results between ENT specialists and GPs using a conventional otoscope (P=0.0032); this was not the case when GPs used video-otoscopy (P=0.0754). All GPs expressed enthusiastic interest in video-otoscopy, even when not convinced to make the purchase.
Video-otoscopy showed superiority over conventional otoscopy in assessing pathological eardrums.
全科医生(GPs)在耳部疾病的管理中发挥着重要作用,但他们对病理性鼓膜的诊断并不充分。本研究的目的是比较全科医生使用传统耳镜与视频耳镜进行耳镜检查诊断的质量。
11名全科医生纳入了124例有耳部不适的患者(共进行了193次耳镜检查)。检查依次使用传统耳镜检查和视频耳镜检查。每种检查类型后,填写一份包含10项标准的评估问卷并提出诊断。两名不知情的耳鼻喉科专家查看视频耳镜检查图像并填写相同的方格问卷以做出诊断。全科医生还完成了一份关于视频耳镜检查的李克特量表满意度问卷。
三组(全科医生传统耳镜检查、全科医生视频耳镜检查和耳鼻喉科专家)的总体检查结果没有显著差异。然而,仅关注病理性鼓膜时,耳鼻喉科专家与使用传统耳镜的全科医生之间的结果存在显著差异(P = 0.0032);而全科医生使用视频耳镜检查时则不存在这种情况(P = 0.0754)。所有全科医生对视频耳镜检查都表现出浓厚兴趣,即使他们不打算购买。
在评估病理性鼓膜方面,视频耳镜检查显示出优于传统耳镜检查的优势。