title: Video-otoscopy recordings for diagnosis of childhood ear disease using telehealth at primary health care level.
abstract: We studied the diagnoses made by an otologist and general practitioner (GP) from video-otoscopy recordings on children made by a telehealth facilitator. The gold standard was otomicroscopy by an experienced otologist. A total of 140 children (mean age 6.4 years; 44% female) were recruited from a primary health care clinic. Otomicroscopic examination was performed by an otologist. Video-otoscopy recordings were assigned random numbers and stored on a server. Four and eight weeks later, an otologist and a GP independently graded and made a diagnosis from each video recording. The otologist rated the quality of the video-otoscopy recordings as acceptable or better in 87% of cases. A diagnosis could not be made from the video-otoscopy recordings in 18% of ears in which successful onsite otomicroscopy was conducted. There was substantial agreement between diagnoses made from video-otoscopy recordings and those from onsite otomicroscopy (first review: otologist κ = 0.70 and GP κ = 0.68; second review: otologist κ = 0.74 and GP κ = 0.75). There was also substantial inter-rater agreement (κ = 0.74 and 0.74 at the two reviews) and intra-rater agreement (κ = 0.77 and 0.74 for otologist and GP, respectively). A telehealth facilitator, with limited training, can acquire video-otoscopy recordings in children for asynchronous diagnosis. Remote diagnosis was similar to face-to-face diagnosis in inter- and intra-rater variability.
authors: Department of Communication Pathology, University of Pretoria, South Africa leigh.biagio@up.ac.za.
authors: Leigh
authors: L
authors: Biagio
authors: Department of Communication Pathology, University of Pretoria, South Africa Ear Sciences Centre, School of Surgery, University of Western Australia, Nedlands, Australia Ear Science Institute Australia, Subiaco, Australia.
authors: De Wet
authors: de W
authors: Swanepoel
authors: Department of Communication Pathology, University of Pretoria, South Africa ENT Unit, Department of Clinical Science, Umeå University, Sweden.
authors: Claude
authors: C
authors: Laurent
authors: Family Medicine, Department of Public Health and Clinical Medicine, Umeå University, Sweden.
authors: Thorbjörn
authors: T
authors: Lundberg
mesh_terms: D000293:Adolescent; D002648:Child; D002675:Child, Preschool; D005194:Family Practice / Q000379:methods*; D005260:Female; D006801:Humans; D008297:Male; D015588:Observer Variation; D010033:Otitis Media / Q000175:diagnosis*; D038781:Otoscopy / Q000379:methods*; D017216:Telemedicine / Q000379:methods*; D014741:Video Recording