Video-otoscopy recordings for diagnosis of childhood ear disease using telehealth at primary health care level.
JOURNAL OF TELEMEDICINE AND TELECARE(2014)
摘要
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 kappa = 0.70 and GP kappa = 0.68; second review: otologist kappa = 0.74 and GP kappa = 0.75). There was also substantial inter-rater agreement (kappa = 0.74 and 0.74 at the two reviews) and intra-rater agreement (kappa = 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.
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关键词
paediatric
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