Improving Rural Access to Pediatric Healthcare with Accurate Telehealth Diagnosis of Acute Otitis Media using Smartphone Acoustic Reflectometry

使用智能手机声反射测量法对急性中耳炎进行准确的远程医疗诊断，改善农村获得儿科医疗保健的机会

• 批准号: 10710056
• 负责人: Judson Heugel
• 金额: $ 85.98万
• 依托单位: WAVELY DIAGNOSTICS, INC.
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-25 至 2024-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10710056
• 关键词: Acoustics; Acute; Affect; Age; Agreement; Algorithms; Calibration; Caregivers; Caring; Cellular Phone; Child; Child health care; Childhood; Classification; Clinic; Clinic Visits; Clinical; Clinical Research; Communities; Computerized Medical Record; Data; Detection; Devices; Diagnosis; Diagnostic; Digital Signal Processing; Ear; Education; External auditory canal; Face; Fees; Goals; Grant; Hand; Health Insurance Portability and Accountability Act; Health Services; Home; Image; Infrastructure; Investments; Legal patent; Letters; Modeling; Noise; Otitis Media; Otolaryngologist; Otoscopes; Outcome; Paper; Parents; Pathway interactions; Patients; Perforation; Persons; Phase; Physicians; Price; Process; Provider; Qualifying; Rural; Rural Community; Rural Population; Scanning; Sensitivity and Specificity; Services; Signal Transduction; Small Business Innovation Research Grant; Specificity; Speech Delay; System; Techniques; Technology; Telemedicine; Telephone; Testing; Tympanic membrane; Tympanometry; Underserved Population; Visit; accurate diagnosis; aged; application programming interface; commercial application; cost; cost effective; digital; ear infection; electric impedance; health care availability; hearing impairment; improved; interest; machine learning algorithm; microphone; middle ear fluid; smartphone application; smartphone based device; sound; telehealth; tool; virtual

PROJECT SUMMARY Acute otitis media (AOM) is a leading cause of pediatric visits each year, affecting 85% of children under the age of 3. There are 18 million annual doctor visits due to suspected AOM, which today are challenging to conduct over telehealth because diagnosis traditionally requires an in-person physical exam. This is particularly problematic for rural children who can’t easily access healthcare services leading to possible complications from under-treatment (hearing loss, speech delay, eardrum perforation). Current telehealth services lack technology to successfully conduct a middle ear fluid exam, the key finding of the physical exam for an AOM. Wavely Diagnostics is developing a smartphone-based tool for lay users that accurately detects middle ear fluid during a telehealth visit. Our technology uses acoustic reflectometry—an impedance-based technique that reflects sound chirps off the eardrum—paired with machine learning algorithms to determine middle ear fluid status. In this Direct to Phase II SBIR project, the specific aims are: 1) develop an in-field calibration process to drive compatibility across smartphones, 2) clinically demonstrate accuracy of middle ear fluid detection with device as compared to physician assessment, 3) develop a HIPAA-compliant Wavely Application Programing Interface (API) to integrate with a telemedicine platform, and 4) validate the clinical utility of Wavely Middle Ear Fluid Scanner for diagnosing AOM in a telemedicine setting. The expected outcome of this proposal is a Middle Ear Fluid Scanner for AOM detection that will be ready for widescale use by telehealth services supporting rural populations. Given the ubiquity of smartphones across all communities, recent rise in telehealth usage particularly in rural communities where significant investment is being made in broadband services, and the critical need for accurate remote diagnostics, our proposed system has the potential to significantly improve healthcare access for the 13.4 million children in rural communities.

项目摘要 急性中耳炎（AOM）是每年小儿就诊的主要原因，影响了85％的儿童 年龄3岁。由于怀疑AOM，每年有1800万例医生就诊，今天挑战 对远程医疗进行进行进行，因为传统上诊断需要进行面对面的身体检查。这是 对于无法轻松访问医疗保健服务的粗糙儿童而言，特别是有问题的 治疗不足的并发症（听力损失，语音延迟，耳朵穿孔）。当前的远程医疗 服务缺乏成功进行中耳流体考试的技术，这是体格检查的关键发现 对于AOM。波浪诊断正在为外行用户开发基于智能手机的工具，以准确检测到 远程医疗访问期间中耳液。我们的技术使用声学反射仪 - 基于阻抗的 反映出声音鸣叫的技术 - 用机器学习算法绘制 中耳液状态。在此直接到II阶段SBIR项目中，具体目的是：1）开发场地 校准过程以驱动跨智能手机的兼容性，2）在临床上证明了中耳的准确性 与物理评估相比，用设备进行流体检测，3）符合HIPAA的波浪 应用程序编程接口（API）与远程医疗平台集成，4）验证临床 在远程医疗环境中，波浪中耳流体扫描仪用于诊断AOM的效用。预期 该提案的结果是用于AOM检测的中耳流体扫描仪 由远程医疗服务支持​​农村人口。考虑到所有社区中智能手机的普遍性， 远程医疗使用量的最新增长，特别是在农村社区正在进行大量投资 宽带服务以及对准确远程诊断的关键需求，我们提出的系统具有 有可能显着改善农村社区1340万儿童的医疗保健机会。