Evaluating the efficacy of digital otoscopes in rural pediatric otitis media diagnosis: A comparative study of general practitioners and ENT specialists.

Abstract

Otitis media is a prevalent childhood illness, particularly among specific groups. However, its diagnosis has been of a serious issue, which is exacerbated in underprivileged regions with limited access to Ear, nose and throat specialists. This study aimed to evaluate the agreement between diagnoses of ear diseases made by general practitioners using digital otoscope and standard otoscope, and the diagnoses determined by an otolaryngologist, as the gold standard. This study examined ear examinations in rural health centers, comparing digital otoscope and standard otoscope, screenings by general practitioners (GPs) with remote digital otoscope evaluations by an ENT specialist. The research involved grading tympanic membranes using the OM-grade scale across three diagnostic groups: GP otoscope, ENT video otoscope, and GP video otoscope. Diagnostic agreement was assessed using Cohen's kappa coefficient, and both parents/guardians and physicians provided feedback on the examination methods, exploring the potential of telemedicine in remote medical assessments. A total of 82 children, 45 boys and 37 girls, were included in the study from 4 rural health centers. There was a significant agreement (0.90%) between the diagnoses of the ENT specialist and the general practitioner with the video-otoscope examining the patients' ears. The results of the physician survey showed that the physicians were in complete agreement (100%). The system is easy to use and the video-otoscope can be useful for telemedicine and greater patient interaction. It is worth noting that the results of this study showed a high level of satisfaction (98%) among the parents of the children after exposure. Our findings provide strong evidence that digital video otoscope can enhance the diagnostic accuracy of GPs in detecting ear diseases, especially in settings with limited access to ENT specialists. By facilitating improved visualization, remote consultation, and more efficient referrals, this technology holds promise for empowering primary care providers and expanding the reach of quality ear healthcare. Integration of video otoscope into telemedicine platforms could further support GPs in underserved areas, improving patient outcomes while optimizing healthcare resources.