Acute Otitis Media Clinical Trial
Official title:
Mobile Otoscopy - Efficacy of Residents to Diagnose Acute Otitis Media Using a Smartphone Otoscope Attachment: A Randomized Controlled Trials
To evaluate the residents' efficacy in diagnosing acute otitis media among febrile children presenting with respiratory symptoms using a smartphone otoscope attachment compared with a classic otoscope.
Background: Acute otitis media (AOM) is one of the most common diseases of childhood and a
leading cause for health care consultations. While otoscope is the tool traditionally used
to diagnose AOM, otoscopic diagnostic skills of both trainees and practitioners appear to be
limited. Therefore, new diagnostic methods are continuously developed. One of those devices
is a smartphone otoscope attachment called CellScope Oto, a portable video-otoscope that
allows residents and staff to share diagnostic-quality images.
Objective: To evaluate the residents' efficacy in diagnosing acute otitis media among
febrile children presenting with respiratory symptoms using a smartphone otoscope attachment
compared with a classic otoscope.
Methods: This will be a randomized controlled trial evaluating accuracy of evaluation of
ears of children visiting the emergency department (ED) for suspected AOM by residents using
the CellScope Oto in comparison to a classic otoscope. It will be performed at a single
pediatric ED in a tertiary care Hospital. Participants will be children between 1 and 5
years of age presenting with fever and respiratory symptoms. Baselines characteristics of
participants will be assessed. Participating residents will be taught how to use the
CellScope Oto and will practice with a few patients before being ready to participate in the
study. Eligible patients will be recruited during weekdays. If the parents consent, patients
will first be evaluated by a staff Pediatric Otolaryngologist using a binocular microscope
(gold standard). They will then be evaluated by two participating residents, one using the
intervention method and one using the control. Randomization will be used to decide which
visualisation method will be used first. After all three exams have been performed, the
residents, patients' parent and staff in charge will each be asked to answer a short
questionnaire about final diagnosis and confidence in the performed exam, favourite method
and the need for a control exam. These questionnaires will be reviewed by a reviewer blinded
to the randomization. The primary outcome measure will be the accuracy of AOM diagnosis made
by the residents compared with the diagnosis made by a staff Pediatric Otolaryngologist
using a binocular microscope. A sample size of 100 participants evaluated twice would
provide a power of 80% and an alpha value of 0,05 to demonstrate a difference of 15% in the
rate of appropriate diagnosis of AOM by residents using a smartphone otoscope attachment
compared with classic otoscope use.
Expected results: The investigators expect to demonstrate a 15% increase in the efficacy
rate of AOM diagnosis by residents registered to a paediatrics-related program using a
smartphone otoscope attachment compared with a classic otoscope. This device has the
potential to change current AOM diagnostic practice and might, in turn, provide a reduced
amount of prescriptions made every year for antibiotics.
;
Allocation: Randomized, Endpoint Classification: Safety/Efficacy Study, Intervention Model: Crossover Assignment, Masking: Open Label, Primary Purpose: Diagnostic
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