Comparison of old, professional and consumer model acoustic reflectometers in the detection of middle-ear fluid in children with recurrent acute otitis media or glue ear

Teppo, Heikki; Revonta, Matti

doi:10.1016/j.ijporl.2007.08.013

Cited by 12 publications

(4 citation statements)

References 18 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…Home screening of middle-ear fluid among otitis-prone children could be applicable in the future, if the results of this study can be later confirmed in the home setting. paper, the consumer model SG-AR and professional SG-AR performed equally well in the hands of otolaryngologists in detecting MEF among children [7]. However, to our knowledge no reports evaluating the diagnostic properties of the consumer model AR in the hands of laymen (i.e.…”

Section: Introductionmentioning

confidence: 83%

“…In two previously published studies on home monitoring of children with AR, one used a professional model device and the parents were healthcare professionals [5], and the other concentrated on consumer usage issues such as technical success rate of AR recordings and persistence of results between consecutive recordings, but did not report any parameters of diagnostic performance [6]. When compared with results gained with the consumer model AR by otolaryngologists [7], diagnostic accuracy by parents in this study was similar but the error frequency higher (18% vs. 9%). This was expected, since physicians instinctively know in what direction to point the instrument and how to ''open'' the ear canal by retracting the ear lobe.…”

Section: Comparison With Existing Literaturementioning

confidence: 99%

See 1 more Smart Citation

Consumer acoustic reflectometry by parents in detecting middle-ear fluid among children undergoing tympanostomy

Teppo

Revonta

2009

Scandinavian Journal of Primary Health Care

Self Cite

View full text Add to dashboard Cite

Objective. This study aimed at evaluating the diagnostic accuracy of a consumer model acoustic reflectometer in the hands of parents in the detection of middle-ear fluid among children. Design. Prospective diagnostic study according to STARD guidelines. Acoustic reflectometry recorded by the parents was compared with otomicroscopic myringotomy with suction in general anaesthesia, performed immediately afterwards. Setting. Secondary care (Kanta-Häme Central Hospital, Finland). Patients. Pre-school (B7 years) children undergoing otomicroscopic myringotomy due to recurrent acute otitis media or suspicion of glue ear. Main outcome measures. Sensitivity, specificity, and positive and negative predictive values of acoustic reflectometry. Results. Consumer model acoustic reflectometry performed by parents reached sensitivity of 94% (95% confidence interval 88Á100%) and negative predictive value of 92% (83Á100%) with result 1 (green colour) on a scale of 1Á5. On the other hand, the method was not very specific and positive predictive value was poor. Conclusions. The negative screening result was very reliable. Thus, home screening of otitis among otitis-prone children and home follow-up of resolution of middle-ear fluid afterwards deserves to be studied in the home setting in the future.Key Words: Acoustic reflectometry, diagnosis, middle-ear fluid, otitis media, sensitivity, specificity Acoustic reflectometry (AR) is a method of assessing the probability of middle-ear fluid (MEF) by an instrument emitting a sound frequency spectrum sweep to the tympanic membrane and analysing the intensity and frequency spectrum of the reflecting sound [1]. The acoustic reflectometer is a small, lightweight, and cordless instrument, the tip of which is inserted at the end of the ear canal and directed towards tympanic membrane during recording, which takes approximately five seconds. It is generally easy to perform and has a high success rate even among crying and struggling children [2], suggesting a possibility for home usage by parents. Newer second-generation acoustic reflectometry (SG-AR) has been proved to be comparable to tympanometry in detecting MEF among children younger than two years [3]. In our previous study [4], SG-AR in the hands of nurses reached a sensitivity and specificity of 96% and 87% among children. Home monitoring with AR was studied by Barnett et al. [5]: parents were able to obtain valid readings in 80% of attempts. The professional SG-AR model used in the above-mentioned studies was followed by a consumer model. Block et al. demonstrated that parents are capable of using the consumer AR device, taking accurate readings, and interpreting them [6]. Moreover, the AR readings made by parents showed good concordance with those obtained by trained nurses. In our recent Prior to the present study, the diagnostic capability of a consumer model acoustic reflectometer has not been validated in the hands of layman consumers, e.g. parents.. Negative screening result obtained by parents, indicating healthy ear, p...

show abstract

Section: Introductionmentioning

confidence: 83%

Section: Comparison With Existing Literaturementioning

confidence: 99%

Consumer acoustic reflectometry by parents in detecting middle-ear fluid among children undergoing tympanostomy

Teppo

Revonta

2009

Scandinavian Journal of Primary Health Care

Self Cite

View full text Add to dashboard Cite

show abstract

“…Unfortunately, the size of the ear canal, the middle-ear pressure, the position of the TM, and the amount of MEE may all influence the spectral gradient curve making results debatable [ 52 , 53 ]. Finally, a supine position [ 54 ] and anesthesia [ 55 ] can significantly influence AR accuracy for MEE detection. Comparative studies have generally reported that the accuracy of AR for MEE detection is quite like that of PO and TP or, in some cases, PO and TP in validated hands are slightly more accurate [ 44 , 56 , 57 , 58 ].…”

Section: Currently Used Methods To Diagnose Acute Otitis Media (Aom)mentioning

confidence: 99%

New Approaches and Technologies to Improve Accuracy of Acute Otitis Media Diagnosis

et al. 2021

View full text Add to dashboard Cite

Several studies have shown that in recent years incidence of acute otitis media (AOM) has declined worldwide. However, related medical, social, and economic problems for patients, their families, and society remain very high. Better knowledge of potential risk factors for AOM development and more effective preventive interventions, particularly in AOM-prone children, can further reduce disease incidence. However, a more accurate AOM diagnosis seems essential to achieve this goal. Diagnostic uncertainty is common, and to avoid risks related to a disease caused mainly by bacteria, several children without AOM are treated with antibiotics and followed as true AOM cases. The main objective of this manuscript is to discuss the most common difficulties that presently limit accurate AOM diagnosis and the new approaches and technologies that have been proposed to improve disease detection. We showed that misdiagnosis can be dangerous or lead to relevant therapeutic mistakes. The need to improve AOM diagnosis has allowed the identification of a long list of technologies to visualize and evaluate the tympanic membrane and to assess middle-ear effusion. Most of the new instruments, including light field otoscopy, optical coherence tomography, low-coherence interferometry, and Raman spectroscopy, are far from being introduced in clinical practice. Video-otoscopy can be effective, especially when it is used in association with telemedicine, parents’ cooperation, and artificial intelligence. Introduction of otologic telemedicine and use of artificial intelligence among pediatricians and ENT specialists must be strongly promoted in order to reduce mistakes in AOM diagnosis.

show abstract

“…Since the introduction of the first acoustic reflectometers in the early 1980s, 9 these devices have undergone major improvements and they now include a spectral gradient analysis. 10,11 Despite the potential advantages of spectral gradient acoustic reflectometry (SGAR) over tympanometry, 10,12 few studies have assessed the diagnostic accuracy of SGAR in the outpatient setting where the method would be of the greatest value. [13][14][15][16] In a prospective study of respiratory infections in children, we directly compared the performance of SGAR and tympanometry in unselected children seen in primary care.…”

mentioning

confidence: 99%

Comparison of Spectral Gradient Acoustic Reflectometry and Tympanometry for Detection of Middle-ear Effusion in Children

Puhakka¹,

Pulkkinen²,

Silvennoinen

et al. 2014

Pediatric Infectious Disease Journal

View full text Add to dashboard Cite

show abstract

Comparison of old, professional and consumer model acoustic reflectometers in the detection of middle-ear fluid in children with recurrent acute otitis media or glue ear

Cited by 12 publications

References 18 publications

Consumer acoustic reflectometry by parents in detecting middle-ear fluid among children undergoing tympanostomy

Consumer acoustic reflectometry by parents in detecting middle-ear fluid among children undergoing tympanostomy

New Approaches and Technologies to Improve Accuracy of Acute Otitis Media Diagnosis

Comparison of Spectral Gradient Acoustic Reflectometry and Tympanometry for Detection of Middle-ear Effusion in Children

Contact Info

Product

Resources

About