iPhone otoscopes: Currently available, but reliable for tele-otoscopy in the hands of parents?

Shah, Milan; Sohal, Maheep; Valdez, Tulio A.; Grindle, Christopher R.

doi:10.1016/j.ijporl.2018.01.003

Cited by 49 publications

(77 citation statements)

References 13 publications

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“…For instance, several studies assessed the CSO. Although the CSO performed as well or better than a traditional otoscope in studies among pediatric patients and in a neurotrauma clinic, the CSO images taken by parents appeared unsuitable for diagnosis . In addition, in a comparison of the CSO to the DMV, no difference was identified between the scopes .…”

Section: Discussionmentioning

confidence: 92%

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A Comparison of Four Digital Otoscopes in a Teleconsultation Setting

et al. 2019

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Objectives/Hypothesis: This study compares image quality and appropriateness for teleconsultations for three different otological conditions. Study Design: Web-based survey.Methods: We compared four digital otoscopes via a Web-based questionnaire distributed to all Finnish ear, nose, and throat (ENT) specialists and residents. The survey consisted of three fictional patient cases, each of which was presented with images taken using the otoscopes studied. Respondents assessed the image quality on a visual analog scale (VAS), assessing its appropriateness for teleconsultations and comparing images taken using different otoscopes to one another.Results: In total, 98 individuals responded, consisting of 81 ENT specialists and 17 ENT residents. The CellScope Oto and Digital MacroView received higher VAS scores for image quality and appropriateness for teleconsultations than the FireFly and Delfino otoscopes (P < .001 for all comparisons). Respondents considered the CellScope Oto more appropriate for teleconsultations for exostoses than the three other otoscopes. The CellScope Oto and Digital MacroView were equally appropriate in the two other cases (normal ear and perforated tympanic membrane).Conclusions: Both digital otoscopes and the underlying otological conditions affect the appropriateness of teleconsultations. Moreover, both factors should be considered when evaluating the suitability of otologic teleconsultations. Among the otoscopes evaluated, images taken using the CellScope Oto received the best overall assessments.

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Section: Discussionmentioning

confidence: 92%

“…The majority of video‐otoscopes have been rated as acceptable or better in several studies . However, image quality also appears to vary between devices as well as between examiners …”

Section: Introductionmentioning

confidence: 99%

A Comparison of Four Digital Otoscopes in a Teleconsultation Setting

et al. 2019

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“…They concluded that parents were able to reliably perform video otoscopy for diagnosing otitis media with effusion in children aged 6‐35 months emphasizing the value of video over still images to improve diagnostic accuracy by the receiving clinician. Conversely, Shah et al demonstrated a large interoperator variability of agreement for diagnosis of ear examinations between a trained professional against a parent who had watched a video tutorial on examining the ear. They stress caution in relying on parents to provide diagnostic video information despite the high rated quality of the images some of these devices may provide.…”

Section: Discussionmentioning

confidence: 99%

Telescopic otology referrals: Evaluation of feasibility and acceptability

Cottrell¹,

George

Coulson

et al. 2020

Laryngoscope Investig Oto

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Objective: A remote telemedical otology referral and advice service was introduced to interested general practices. General practitioners (GPs) were given a new device, "endoscope-i" that combines an optimized smartphone high definition video app with an otoendoscope. They were specifically trained to examine and capture images of patients' eardrums, which were sent electronically with a summary of clinical information and an in-app hearing testing (if required), for specialist advice to two ear, nose, and throat (ENT) consultants. We describe the findings from an evaluation of the first 6 months of this service to establish the feasibility and acceptability of an otology telemedical referral and advice service. Methods:The new service was advertised to GP practices in Northern Staffordshire.All interested GPs were provided with training and equipment to deliver the remote referral service. Data were collected from GPs at baseline, informal feedback in response to referral outcomes and end of service feedback. Referral data were collected routinely during the service delivery.Results: Fifteen GP leads from 15 practices received training and equipment. One quickly lost the equipment. Of the remaining 14 practices, eight sent a total of 53 remote referrals using this technology over 6 months. The most common reason for referral was an uncertainty of what could be seen in or around the eardrum. The primary barrier for implementation was lack of wireless internet connections within practices. GPs reported that they used this technology to share examination findings with patients. Conclusions:GPs were positive about the technology, from initial engagement with training and after advice were given. Some GPs expanded the role of the technology to a consultation aid. Referral volume was manageable. Commissioners should consider tariffs structures for such services; empirical cost-effectiveness and workloadimpact evaluation would inform this.

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“…Finally, because smartphone‐recorded oculography videos appear to be reliable, we believe in the future a smartphone‐based VNG could easily be designed to further allow for telemedical consults for both acute and nonacute vertigo. Smartphones have already been utilized in otolaryngology to create telemedical otoscopes, such as the CellSCope iPhone Otoscope . With a simple combination of Frenzel goggles and a case‐like element to attach a smartphone, the high‐definition camera present in many phones could be utilized for oculography, and an application could provide interpretation.…”

Section: Discussionmentioning

confidence: 99%

“…Smartphones have already been utilized in otolaryngology to create telemedical otoscopes, such as the CellSCope iPhone Otoscope. 10 With a simple combination of Frenzel goggles and a case-like element to attach a smartphone, the high-definition camera present in many phones could be utilized for oculography, and an application could provide interpretation. This could have a twofold benefit of decreasing costs of existing VNG devices and potentially increasing adoption of protocols like those cited by Newman-Toker et al, 6 while also enabling easier telemedical transmission for potential remote consults.…”

Section: Discussionmentioning

confidence: 99%

Smartphone telemedical emergency department consults for screening of nonacute dizziness

et al. 2018

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Objectives/Hypothesis Each year, the United States spends over $4 billion on emergency department visits for evaluation of dizziness. Benign paroxysmal positional vertigo (BPPV) is a common cause of dizziness that can easily be diagnosed by observing characteristic eye movements during the Dix‐Hallpike test (DHT). The DHT is easily performed; however, interpretation requires more advanced training. This may be part of the reason it is not commonly performed in emergency departments, and instead, patients undergo costly imaging tests. We evaluated whether smartphone‐based video recordings of DHT could be assessed telemedically for screening of nonacute dizziness. Study Design Feasibility study. Methods Dizzy patients underwent objective vestibular testing, but also had videos of their eye movements recorded via a smartphone during the DHT. The videos were remotely reviewed by two neuro‐otologists for BPPV screening and were compared to objective and in‐person exam findings. Results Overall, 30 dizzy patients were evaluated with seven cases of BPPV. The sensitivity for diagnosing BPPV via a smartphone‐recording of eye movements of the DHT was 92.86%, with a specificity of 100% and a negative predictive value of 97.87%. Conclusions Our initial proof‐of‐concept study shows that remote screening of BPPV is possible with high specificity. Because the DHT is easily taught, having a remote otolaryngologist interpret the resulting eye movements may increase usage of the test and may lead to cost savings. Level of Evidence 4 Laryngoscope, 129:466–469, 2019

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iPhone otoscopes: Currently available, but reliable for tele-otoscopy in the hands of parents?

Cited by 49 publications

References 13 publications

A Comparison of Four Digital Otoscopes in a Teleconsultation Setting

A Comparison of Four Digital Otoscopes in a Teleconsultation Setting

Telescopic otology referrals: Evaluation of feasibility and acceptability

Smartphone telemedical emergency department consults for screening of nonacute dizziness

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