Reliability and Accuracy of Remote Fiberoptic Nasopharyngolaryngoscopy in the Pediatric Population
| Autor: | Lauren E. Miller, Lisa Elden, Rachel Rogers, Angel G. Ortiz, Kellye O. Jones-Ho, Adva Buzi, Ashley Williams |
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| Rok vydání: | 2020 |
| Předmět: |
Male
medicine.medical_specialty Telemedicine Adolescent 020205 medical informatics Diagnostic accuracy 02 engineering and technology Nose Otolaryngology 03 medical and health sciences 0302 clinical medicine Component (UML) 0202 electrical engineering electronic engineering information engineering medicine Fiber Optic Technology Humans Single-Blind Method Medical physics Prospective Studies Child 030223 otorhinolaryngology Reliability (statistics) Observer Variation Laryngoscopy business.industry Infant Reproducibility of Results Medical practice Otorhinolaryngologic Diseases Otorhinolaryngology Child Preschool Pharynx Female Larynx business Pediatric population |
| Zdroj: | Ear, Nose & Throat Journal. 100:604-609 |
| ISSN: | 1942-7522 0145-5613 |
| DOI: | 10.1177/0145561320919109 |
| Popis: | Introduction: Telemedicine is an increasingly prevalent component of medical practice. In otolaryngology, there is the potential for telemedicine services to be performed in conjunction with device use, such as with a nasolaryngoscope. This study evaluates the reliability of remote examinations of the upper airway through an iPhone recording using a coupling device attached to a nasopharyngolaryngoscope (NPL). Methods: A prospective, blinded study was performed for pediatric patients requiring an NPL during an office visit. The NPL was performed using a coupling device attached to a smartphone to record the examination. A second, remote otolaryngologist then evaluated the recorded examination. Both otolaryngologists evaluated findings of anatomic sites including nasopharynx, oropharynx, base of tongue, larynx including subsites of epiglottis, arytenoids, aryepiglottic folds, false vocal cords, true vocal cords, patency of airway, and diagnostic impression, all of which were documented through a survey. Results of the survey were evaluated through inter-rater agreement using the κ statistic. Results: Forty-five patients underwent an NPL, all of which were included in the study. The average age was 4.9 years. The most common complaint requiring NPL was noisy breathing (n = 16). The inter-rater agreement for overall diagnosis was 0.74 with 80% percent agreement, rated as “good.” Other anatomic subsites with “good” or better inter-rater agreement were nasopharynx (0.75), oropharynx (0.75), and true vocal cords (0.71), with strong percentage agreement of 89%, 91%, and 87%, respectively. Both users of the adaptor found the recording setup to run smoothly. Conclusion: A telemedicine device for NPL use demonstrates strong diagnostic accuracy across providers and good overall evaluation. It holds potential for use in remote settings. |
| Databáze: | OpenAIRE |
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