title: Diagnosis of middle ear disease using tympanograms and digital imaging.
abstract: OBJECTIVE
  The study investigates the ability of physicians with different levels of training to accurately identify middle ear (ME) pathology using tympanograms and tympanic membrane (TM) digital photographs.
  
  
  METHODS
  Groups of medical students, internal medicine residents, and attending and resident otolaryngologists were presented with a set of 50 matched tympanograms and photographs of TMs. The physicians were asked to differentiate between a normal and an abnormal-appearing TM. The sensitivity and specificity of diagnosis of ME pathology by physicians were compared with the gold standard, examining the ME cavity for pathology during myringotomy.
  
  
  RESULTS
  The sensitivity did not vary among physicians with different levels of training; however, specificity improved with an increase in physician experience.
  
  
  CONCLUSIONS
  This study establishes a baseline for accuracy of diagnosis of ME pathology using tympanograms and photographs of TMs as compared with binocular otomicroscopy and the gold standard, myringotomy.
  
  
  METHODS
  B-2.
authors.affiliation: Department of Otolaryngology--Head and Neck Surgery, University of Pennsylvania Medical Center, Philadelphia, USA.
authors.forename: Anna
authors.initials: A
authors.lastname: Aronzon
authors.forename: Adam T
authors.initials: AT
authors.lastname: Ross
authors.forename: Ken
authors.initials: K
authors.lastname: Kazahaya
authors.forename: Masaru
authors.initials: M
authors.lastname: Ishii
mesh_terms: D000158:Acoustic Impedance Tests / Q000379:methods*; D002648:Child; D002675:Child, Preschool; D002983:Clinical Competence; D005260:Female; D006801:Humans; D007223:Infant; D007388:Internal Medicine / Q000592:standards; D008297:Male; D008876:Middle Ear Ventilation; D010033:Otitis Media / Q000175:diagnosis* / Q000601:surgery; D010036:Otolaryngology / Q000592:standards; D010781:Photography / Q000379:methods; D012680:Sensitivity and Specificity; D013337:Students, Medical; D017216:Telemedicine; D014432:Tympanic Membrane / Q000473:pathology* / Q000503:physiopathology