Smartphone-Enabled Otoscopy in Neurotology/Otology
Smartphone-Enabled Otoscopy in Neurotology/Otology
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DOI：
10.1177/0194599816687740
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发表时间：
2017-03-01
影响因子：
3.4
通讯作者：
Djalilian, Hamid R.
中科院分区：
文献类型：
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作者：
Moshtaghi, Omid;Sahyouni, Ronald;Djalilian, Hamid R.
目标。智能手机耳镜(SEO)可以捕捉鼓膜(TM)图像。我们试图在耳科/神经病学实践中比较SEO和显微镜耳镜在检测和评估TM病理方面的作用。在3个月以上的成人中进行前瞻性单部位研究。三级医疗学术医疗中心内的神经内科诊所。对象和方法。在同意后，57名患者接受了内科和显微镜下的耳朵检查。之后，临床医生使用SEO拍摄了双侧TMS。第二个“失明的”神经科医生收到了每个TM的SEO获得的图像和简短的患者病史。我们的主要目的是确定TM病理(或缺乏)和盲目神经科医生的相应诊断。次要终点包括患者报告的SEO舒适度。单一SEO获取的TM图像和简短的患者病史导致96%(23/24)正常TMS的正确诊断和100%(33/33)显微镜证实的异常TMS的识别。当病理被“盲人”医生确认时，诊断结果与主治医师所作的诊断一致的概率为82%(27/33)。在患者调查中，93%(53/57)的患者对SEO的使用感到“非常舒服”，88%(50/57)的患者报告说，查看获得的图像对于了解他们的情况“非常有用”。SEO在识别正常TM方面的特异性为96%，在识别病理方面的敏感性为100%。其97%的阳性预测值和较小的假阳性率使其成为一种有用的筛查工具。此外，患者容易接受这项技术，并对其在医疗保健或可能的远程医疗环境中的使用感到舒服。
Objective. A smartphone-enabled otoscope (SEO) can capture tympanic membrane (TM) images. We sought to compare a SEO to microscopic otoscopy in the detection and evaluation of TM pathology in an otology/neurotology practice.Study Design. Prospective single-site study in adults presenting over a 3-month period.Setting. Neurotology clinic within a tertiary care academic medical center.Subjects and Methods. Following consent, 57 patients underwent a medical and microscopic ear examination. Afterward, clinicians photographed bilateral TMs using a SEO. A second "blinded'' neurotologist received a SEO-acquired image of each TM and a brief patient history. Our primary end point was identification of TM pathology (or lack thereof) and the blinded neurotologists' corresponding diagnosis. Secondary end points included patient-reported SEO comfort levels.Results. A single SEO-acquired TM image and brief patient history resulted in correct diagnosis of 96% (23/24) of normal TMs and identification of 100% (33/33) of microscope-confirmed abnormal TMs. When pathology was identified by the "blinded'' physician, the diagnosis was identical to that made by the primary treating physician 82% (27/33) of the time. On patient surveys, 93% (53/57) of patients felt "very comfortable'' with SEO utilization, and 88% (50/ 57) reported viewing acquired images was "very useful'' in understanding their condition.Conclusion. A SEO is 96% specific in identifying normal TMs and 100% sensitive in identifying pathology. Its 97% positive predictive value and small false-positive rate makes it a useful screening tool. Furthermore, patients are receptive to this technology and felt comfortable with its utilization in a health care or possible telemedicine setting.