A cross‐sectional evaluation of the validity of a smartphone otoscopy device in screening for ear disease in Nepal

• DOI: 10.1111/coa.12898
• Publication Date: 2017-05-09T07:06:47Z
• Authors: R. Mandavia; T. Lapa; M. Smith; M.F. Bhutta
• Keywords: Concordance; Cross-sectional study; Cohen's kappa; Outpatient clinic

Objectives Hearing loss is a neglected international health problem. The greatest burden of ear disease in low‐income countries where there also lack resources. In this context, screening for otological may be worthwhile. Cupris© has developed an otoscopy device that offers the possibility low‐cost mass remote communities. We evaluated validity diagnosing and determining whether referral to ENT centre warranted. Design Cross‐sectional study. Setting Outpatient clinic, Nepal. Participants All adults children were invited take part over 2‐day period. was used record participants history examination. Stored images assessed United Kingdom by Consultant‐grade Surgeon, who provided diagnosis decided After with device, immediately UK trained Consultant Surgeon using standard otoscope (“standard assessment”). A recorded each participant decision made as Outcomes Concordance primary (analysed per ear) concordance refer patient). Cohen's kappa coefficient inter‐rater agreement diagnosis. Results Fifty‐six patients agreed participate. four patients, quality video precluded or management plan. These excluded from subsequent analysis, leaving 52 analysis. same reached 99 104 ears when comparing assessment (95% concordance), 0.89. patient should referred further all assessment. Conclusions When compared assessment, valid tool onward referral. It shows considerable promise use non‐medical workers, portable screen settings, particularly low‐ middle‐income countries.