Geisel School of Medicine at Dartmouth, Hanover, NH, USA.
Department of Otolaryngology-Head and Neck Surgery, Massachusetts Eye and Ear and Harvard Medical School, Boston, MA, USA.
Ann Otol Rhinol Laryngol. 2022 Oct;131(10):1115-1122. doi: 10.1177/00034894211051810. Epub 2021 Nov 2.
As telemedicine has become increasingly utilized during the COVID-19 pandemic, portable otoendoscopy offers a method to perform an ear examination at home. The objective of this pilot study was to assess the quality of otoendoscopic images obtained by non-medical individuals and to determine the effect of a simple training protocol on image quality.
Non-medical participants were recruited and asked to capture images of the tympanic membrane before and after completion of a training module, as well as complete a survey about their experience using the otoendoscope. Images were de-identified, randomized, and evaluated by 6 otolaryngologists who were blinded as to whether training had been performed prior to the image capture. Images were rated using a 5-point Likert scale.
Completion of a training module resulted in a significantly higher percentage of tympanic membrane visible on otoendoscopic images, as well as increased physician confidence in identifying middle ear effusion/infection, cholesteatoma, and deferring an in-person otoscopy ( < .0001). However, even with improved image quality, in most cases, physicians reported that they would not feel comfortable using the images to for diagnosis or to defer an in-person examination. Most participants reported that the otoendoscope was simple to use and that they would feel comfortable paying for the device.
At-home otoendoscopes can offer a sufficient view of the tympanic membrane in select cases. The use of a simple training tool can significantly improve image quality, though often not enough to replace an in-person otoscopic exam.
随着远程医疗在 COVID-19 大流行期间的应用越来越广泛,便携式耳内镜为在家中进行耳部检查提供了一种方法。本初步研究的目的是评估非医学专业人员获得的耳内镜图像的质量,并确定简单的培训方案对图像质量的影响。
招募非医学专业人员,要求他们在完成培训模块前后拍摄鼓膜的图像,并完成一项关于他们使用耳内镜的体验的调查。对图像进行去识别、随机化处理,然后由 6 名耳鼻喉科医生进行评估,这些医生在评估前对图像采集前是否进行过培训不知情。图像采用 5 分制李克特量表进行评分。
完成培训模块后,耳内镜图像中可观察到鼓膜的比例显著提高,医生对识别中耳积液/感染、胆脂瘤和推迟亲自进行耳镜检查的信心也有所增加( < .0001)。然而,即使图像质量得到改善,在大多数情况下,医生报告说他们不会感到舒适使用这些图像进行诊断或推迟亲自检查。大多数参与者报告说耳内镜使用简单,他们愿意为该设备付费。
在某些情况下,家用耳内镜可以提供足够的鼓膜视图。使用简单的培训工具可以显著提高图像质量,但通常不足以替代亲自进行的耳镜检查。