Abstract
Objective
Acute otitis media (AOM) is a common diagnosis under age 5 years. The primary objective
was to determine if the CellScope Oto (CSO) improves tympanic membrane (TM) visualization
and diagnostic precision compared to traditional otoscope. The secondary objective
was to determine physician, patient, and parent device preference.
Methods
This is a prospective cross-sectional study of patients younger than 18 years presenting
with ear pain, fever, or upper respiratory infection symptoms. Patients were examined
by a resident then attending physician with a traditional wall-mounted otoscope followed
by CSO. Each was blinded to the other's findings. Intrarater and interrater diagnostic
agreement was compared. Physicians, parents, and patients were surveyed regarding
their experience.
Results
A total of 51 patients completed the study. There was substantial intrarater agreement
between traditional otoscope and CSO for residents: right ear (κ = 0.74) and left ear (κ = 0.74); CSO use changed reported view for 16 of 102 TM examinations (16%), of which
7 (7%) had clinically relevant change in diagnosis to/from AOM. There was substantial
to almost-perfect agreement for attending physicians: right: (κ = 0.86) and left (κ = 0.79); CSO use changed reported view for 12 (12%), with 6 (6%) clinically relevant.
Resident/attending physician interrater agreement was moderate for both traditional
otoscope (κ = 0.40) and CSO (κ = 0.47). Physicians agreed CSO was easy to use, enhanced TM visualization and diagnostic
precision, and was a good teaching tool. Patients and parents also found the CSO images
very helpful.
Conclusion
CellScope Oto was preferred by physicians, patients, and parents. Use of the CSO changed
final diagnosis a significant number of times, including clinically relevant changes
to/from AOM.
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Article Info
Publication History
Published online: May 03, 2015
Accepted:
April 27,
2015
Received in revised form:
April 24,
2015
Received:
April 14,
2015
Footnotes
☆Presented at the Society for Academic Medicine Annual Meeting, San Diego, CA, May 15, 2015.
Identification
Copyright
© 2015 Elsevier Inc. Published by Elsevier Inc. All rights reserved.
