The University of Western Australia, Australia.
Telethon Kids Institute, The University of Western Australia, Australia.
J Telemed Telecare. 2023 Jul;29(6):435-443. doi: 10.1177/1357633X20987783. Epub 2021 Jan 26.
Video otoscopy plays an important role in improving access to ear health services. This study investigated the clinician-rated quality of video otoscopy recordings and still images, and compared their suitability for asynchronous diagnosis of middle-ear disease.
Two hundred and eighty video otoscopy image-recording pairs were collected from 150 children (aged six months to 15 years) by an ear, nose, and throat (ENT) specialist, audiologists, and trained research assistants, and independently rated by an audiologist and ENT surgeon. On a five-point scale, clinicians rated the cerumen amount, field of view, quality, focus, light, and gave an overall rating, and asked whether they could make an accurate diagnosis for both still images and recordings.
More video otoscopy recordings were rated as 'good' or 'excellent' compared to still images across all domains. The mean difference between the two otoscopic procedures ratings was significant across almost all domains ( < 0.05), except 'cerumen amount'. The suitability to make a diagnosis significantly improved when using recordings (p<0.05). Younger participant age was found to have a significant, negative impact on the ratings across all domains ( < 0.03). The role of the tester conducting video otoscopy did not have a significant impact on the ratings.
Video otoscopy recordings were found to provide clearer views of the tympanic membrane and increase the ability to make diagnoses, compared to still images, for both audiologists and ENT surgeons. Research assistants with limited practice were able to obtain video otoscopy images and recordings that were comparable to the ones obtained by clinicians.
视频耳镜检查在改善耳部健康服务的可及性方面发挥着重要作用。本研究调查了临床医生对视频耳镜检查记录和静态图像的质量评估，并比较了它们对中耳疾病异步诊断的适用性。
由耳鼻喉科专家、听力学家和经过培训的研究助理从 150 名儿童（6 个月至 15 岁）中收集了 280 对视频耳镜图像记录，并由听力学家和耳鼻喉科外科医生进行独立评估。临床医生使用五分制对耳垢量、视野、质量、焦点、光线以及整体评分进行评估，并询问他们是否可以对静态图像和记录进行准确诊断。
与静态图像相比，视频耳镜检查记录在所有领域的评分中更多地被评为“良好”或“优秀”。两种耳镜检查方法的评分平均值在几乎所有领域都存在显著差异（<0.05），除了“耳垢量”。使用记录进行诊断的适用性显著提高（p<0.05）。参与者年龄越小，所有领域的评分都存在显著的负面影响（<0.03）。进行视频耳镜检查的测试者的角色对评分没有显著影响。
与静态图像相比，视频耳镜检查记录提供了更清晰的鼓膜视图，并提高了听力学家和耳鼻喉科外科医生做出诊断的能力。经过有限实践的研究助理能够获得与临床医生获得的类似的视频耳镜图像和记录。
