Abstract
Background
The CellScope Oto® is a smartphone otoscope attachment allowing physicians to share diagnostic-quality
images of the ears. Our primary objective was to evaluate the residents' accuracy
in diagnosing acute otitis media in children using the CellScope Oto® attachment compared to traditional otoscope.
Methods
A randomized crossover controlled trial was performed at a single, tertiary care,
pediatric emergency department. Participants were a convenience sample of preschool
children, consulting for fever and respiratory symptoms. All children were evaluated
by two residents randomized to use the CellScope Oto® smartphone device or a traditional otoscope. The primary outcome was the diagnostic
accuracy of residents in ear evaluation compared to pediatric otolaryngologist's using
binocular microscopy. Secondary outcomes included the need for a second ear exam by
the treating physician and parental preference.
Results
Between August 2015 and June 2016, 90 residents examined 100 patients. Six patients
were excluded, leaving 94 children evaluated twice. Diagnostic accuracies were 0.69
(95% CI: 0.52 to 0.75) for the residents using a traditional otoscope and 0.74 (95%
CI: 0.68 to 0.80) for those using the CellScope Oto® for an absolute difference of 0.06 (95% CI: −0.03 to 0.15). The emergency physicians
reported no need for a control exam in 49/91 (54%) situations. Finally, 44 (47%) families
preferred the CellScope Oto®, 26 (28%) the traditional otoscope and 23 (25%) had no preference.
Conclusions
Residents using the CellScope Oto® had accuracies as good as those using the traditional otoscope to evaluate the ears
of young children at risk of acute otitis media.
www.clinicaltrials.gov: Identifier NCT02521597.
Keywords
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Article Info
Publication History
Published online: February 04, 2018
Accepted:
January 30,
2018
Received in revised form:
January 23,
2018
Received:
December 22,
2017
Identification
Copyright
© 2018 Elsevier Inc. All rights reserved.
