Appelberg Erik, Viitasalo Sanna, Hafrén Lena, Laakso Juha, Suutarla Samuli, Hopsu Erkki, Sinkkonen Saku T
Department of Otorhinolaryngology - Head and Neck Surgery, Head and Neck Center Helsinki University Hospital and University of Helsinki Helsinki Finland.
Department of Otorhinolaryngology Kymenlaakso Central Hospital Kotka Finland.
Laryngoscope Investig Otolaryngol. 2024 Aug 24;9(4):e70003. doi: 10.1002/lio2.70003. eCollection 2024 Aug.
Otoscopes and otomicroscopes are the most commonly used instruments for visualizing the ear. Digital otoscopy (DO) could be used to improve diagnostics in primary health care by utilizing image enlargement. The aim of the study was to explore the possibilities of DO in remote consultations.
Based on real-life referrals, 45 otologic outpatients were recruited. DO was performed followed by an attending otologist's appointment, serving as the gold standard. Twenty-four patient cases were analyzed on a digital platform as remote consultation cases containing the given referral information supplemented with DO videos (DOVs). A total of 71 evaluations were performed by five otologists. The quality of the DOVs, their suitability for remote consultations, the accuracy of diagnoses and the usefulness of remote consultations were determined.
The average DOV quality was judged to be 7.4 ± 0.3 (mean ± standard error of the mean; scale of 1-10). The diagnosis was correct in 79% of the cases. In 59% of the patients, the otologists considered that remote consultation could have replaced an in-person visit.
In our simulated remote consultation setup, DOV quality was sufficient for diagnostic purposes, DO improved diagnostics and treatment planning in most cases and could be used to reduce the need for in-person visits. DO-aided remote consultation may improve diagnostics and access to care.Level of evidence: 3.
耳镜和耳显微镜是可视化耳部最常用的器械。数字耳镜检查（DO）可通过利用图像放大功能来改善初级卫生保健中的诊断。本研究的目的是探索数字耳镜检查在远程会诊中的可能性。
基于实际生活中的转诊病例，招募了45名耳科门诊患者。先进行数字耳镜检查，然后由主治耳科医生进行会诊，后者作为金标准。在一个数字平台上对24例患者病例进行分析，作为包含给定转诊信息并补充了数字耳镜检查视频（DOVs）的远程会诊病例。共有5名耳科医生进行了71次评估。确定了DOVs的质量、它们对远程会诊的适用性、诊断的准确性以及远程会诊的有用性。
DOVs的平均质量被判定为7.4 ± 0.3（均值 ± 均值标准误差；1 - 10分制）。79%的病例诊断正确。在59%的患者中，耳科医生认为远程会诊可以替代面对面就诊。
在我们模拟的远程会诊设置中，DOVs的质量足以用于诊断目的，数字耳镜检查在大多数情况下改善了诊断和治疗计划，并且可用于减少面对面就诊的需求。数字耳镜检查辅助的远程会诊可能会改善诊断和医疗服务的可及性。证据级别：3级。
