Video-otoscopy recordings for diagnosis of childhood ear disease using telehealth at primary health care level
2014 (English)In: Journal of Telemedicine and Telecare, ISSN 1357-633X, Journal of telemedicine and telecare, ISSN 1758-1109, Vol. 20, no 6, 300-306 p.Article in journal (Refereed) Published
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.
Place, publisher, year, edition, pages
2014. Vol. 20, no 6, 300-306 p.
Medical and Health Sciences
IdentifiersURN: urn:nbn:se:umu:diva-96720DOI: 10.1177/1357633X14541038ISI: 000340600700002PubMedID: 24958356OAI: oai:DiVA.org:umu-96720DiVA: diva2:766565