The clinical impact of bedside fiberoptic laryngoscopic recording on a tertiary consult service

Lozada, Kirkland N.; Morton, Kathryn A.; Stepan, Katelyn; Capo, Joseph; Chai, Raymond L.

doi:10.1002/lary.26821

Cited by 13 publications

(17 citation statements)

References 6 publications

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“…Prior studies have demonstrated strong inter‐rater agreement between resident and attending diagnoses on flexible laryngoscopy . However, in our study, the scope operator and the offsite reviewer did not always agree on the ability to visualize anatomical subsites, which is a more specific characteristic than diagnosis alone.…”

Section: Discussioncontrasting

confidence: 71%

“…A limited number of studies have investigated the value of recording endoscopic exams with smartphone adaptors in terms of diagnostic accuracy and resident education . However, only one previous study has looked at optical parameters .…”

Section: Discussionmentioning

confidence: 99%

“…A limited number of studies have investigated the value of recording endoscopic exams with smartphone adaptors in terms of diagnostic accuracy and resident education. [2][3][4][5] However, only one previous study has looked at optical parameters. 3 Liu et al found no significant difference in video quality ratings between endoscopy video tower recordings and smartphone adapter recordings.…”

Section: Discussionmentioning

confidence: 99%

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Smartphone capture of flexible laryngoscopy: Optics, subsite visualization, and patient satisfaction

2019

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Objective To determine whether a smartphone adaptor can record laryngoscopic videos of adequate quality for clinical diagnosis and communication among otolaryngologists and assess the impact of recorded exams on patient satisfaction. Methods Twenty adult inpatients undergoing flexible laryngoscopy in a tertiary care medical center were prospectively enrolled. Each subject's larynx was visualized with the standard laryngoscope eyepiece and with an attached mobile phone adaptor with video recording capabilities. A 5‐point Likert scale was used by the resident performing the scope to grade the adaptor and eyepiece exams. The same scale was used by an offsite otolaryngology attending to grade the adaptor video. Patients were shown the video, and a satisfaction survey was administered. Results In all patients, the adaptor was easy to use and required minimal setup. Ninety percent of patients reported an increase in satisfaction after watching the video of their exam. The eyepiece was superior to the adaptor in resolution, focus, color fidelity, brightness, and optical fluidity (P < 0.05). The video recording was deemed sufficient for clinical assessment in 90% of cases. The offsite reviewer determined that there would be “little” (15%) or “no value” (65%) in repeating the scope exam in the majority of patients. The laryngeal subsites were equally visible with the eyepiece and the adaptor (“full view,” 85%–100%). Conclusion Laryngoscopy videos recorded by a portable smartphone adaptor are sufficient for clinical evaluation in the majority of cases. This technology may improve patient satisfaction and communication among clinicians. Level of Evidence 4 Laryngoscope, 129:2147–2152, 2019

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Section: Discussioncontrasting

confidence: 71%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Smartphone capture of flexible laryngoscopy: Optics, subsite visualization, and patient satisfaction

2019

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“…The clinical utility of smartphone adaptors for FNL was examined by Quimby et al in a systematic review, which identified high diagnostic accuracy, quality, and enhancement of resident education . Smartphone‐coupled FNL portable recording systems were compared to endoscopy towers by Lozada et al in a blinded study, and found good concordance between exams, having only to repeat 1 in 79 examinations (1.3%) due to image quality concerns . While this study did not use our adaptor specifically, we believe from experience that our adaptor provides similar image quality to commercial alternatives.…”

Section: Discussionmentioning

confidence: 99%

“…There are a multitude of smartphone adaptors available from various third party manufacturers allowing for examinations to be recorded and viewed on a larger screen in real time. This offers diagnostic benefit, educational value, and reduces the need to re‐scope patients when findings are unclear to the primary operator . These adaptors are either designed for a specific brand of nasendoscopes, or can be generic telescope or binocular adaptors .…”

Section: Introductionmentioning

confidence: 99%

A 3D printed smartphone adaptor for nasolaryngoscopy

Thompson

Albarki

Lodhia

et al. 2020

Laryngoscope Investig Oto

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Objective The objective of this project is to create a three‐dimensional (3D) printed smartphone adaptor for flexible nasolaryngoscopy (FNL) to provide an affordable alternative to commercial options and a better fit than generic telescope phone adaptors. Method We designed an adaptor using computer aided software to connect an iPhone XS to an Olympus Rhino‐Laryngo Fibre Scope. We experimented with various 3D printing materials and iterative designs to create a case that allowed for quality recording of a nasolaryngoscope exam using the iPhone's built in ×2 telescopic zoom lens. Results Our 3D printed adaptor provides a cost‐effective alternative to commercially available FNL smartphone adaptors and is capable of capturing high‐quality images and videos of the nasopharynx and larynx. These images are useful for senior clinician review, decrease the need for repeat examination, can be utilized for education, avail telehealth review, and provides a way to digitally record examinations to electronic medical records for future comparison without the need for an endoscopy tower. Conclusion Smartphone adaptors for FNL have been established to be of clinical value. Despite being simple devices, they continue to be expensive. This potentially limits access to junior clinicians, who stand to gain most from the ability to review images of examinations with senior colleagues. Our 3D printed smartphone case provides a cost‐effective alternative, with a better fit than generic adaptors, at a print cost of $29 AUD. This is $131 AUD less than the next cheapest commercial alternative. The files are freely available for use and modification. Level of Evidence 4

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Telemedicine Services Provided to Medicare Beneficiaries by Otolaryngologists Between 2010 and 2018

Miller

Rathi

Kozin

et al. 2020

JAMA Otolaryngol Head Neck Surg

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IMPORTANCEClinicians are increasingly adopting telemedicine in an effort to expand patient access and efficiently deliver care. However, the extent to which otolaryngologists provide telemedicine services is unclear.OBJECTIVE To characterize recent trends in the use of telemedicine by otolaryngologists to deliver care to Medicare beneficiaries. DESIGN, SETTING, AND PARTICIPANTSA retrospective cross-sectional analysis was conducted between January 1, 2010, and December 31, 2018, using publicly available Medicare Physician/Supplier Procedure Summary data on physicians practicing in the field of otolaryngology and benchmark specialties (dermatology and psychiatry) that provided telemedicine services to Medicare beneficiaries. MAIN OUTCOMES AND MEASURESPrimary outcomes were the mean annual number of telemedicine services delivered per active physician and mean annual payment per active physician for these services. Secondary outcomes included the number, setting, and complexity of telemedicine services.RESULTS Between 2010 and 2018, otolaryngologists provided 2127 total telemedicine services (7 unique service types) to Medicare beneficiaries and received $88 574 in total payment for these services. During this period, the mean number of telemedicine services increased at a compound annual growth rate (CAGR) of 11.0%, and the mean Medicare payment per otolaryngologist increased at a CAGR of 21.8%. In comparison, telemedicine use during this period generally increased at a higher rate in the fields of dermatology (mean number of services per active physician at CAGR of 13.0%; mean Medicare payment per active physician at CAGR of 12.5%) and psychiatry (mean number of services per active physician at CAGR of 25.8%; mean Medicare payment per active physician at CAGR of 26.6%). In 2018, outpatient evaluation and management visits accounted for most telemedicine services provided (337 of 353 [95.5%]) and the payments received ($17 542.13 of $18 470.47 [95.0%]) by otolaryngologists. In contrast, physicians in other specialties also provided substantial portions of telemedicine services in the inpatient (psychiatry, 18 403 of 198 478 [9.3%]; dermatology, 231 of 1034 [22.3%]) and skilled nursing facility settings (psychiatry, 14 690 of 198 478 [7.4%]; dermatology, 46 of 1034 [4.4%]). CONCLUSIONS AND RELEVANCEThis study suggests that the extent to which otolaryngologists used telemedicine to deliver care to Medicare beneficiaries between 2010 and 2018 was rare. Although there was relative growth in the use of telemedicine by otolaryngologists during this period, absolute growth remained low. Policy makers and provider organizations should support otolaryngologists in the adoption of telemedicine technologies, especially while coronavirus disease 2019 (COVID-19) viral suppression efforts necessitate prolonged restriction of physical clinic throughput.

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The clinical impact of bedside fiberoptic laryngoscopic recording on a tertiary consult service

Abstract: 4. Laryngoscope, 128:818-822, 2018.

Cited by 13 publications

References 6 publications

Smartphone capture of flexible laryngoscopy: Optics, subsite visualization, and patient satisfaction

Smartphone capture of flexible laryngoscopy: Optics, subsite visualization, and patient satisfaction

A 3D printed smartphone adaptor for nasolaryngoscopy

Telemedicine Services Provided to Medicare Beneficiaries by Otolaryngologists Between 2010 and 2018

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