{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T04:37:08Z","timestamp":1790829428460,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"12","license":[{"start":{"date-parts":[[2024,7,10]],"date-time":"2024-07-10T00:00:00Z","timestamp":1720569600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100020021","name":"Avant Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100020021","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003354","name":"Garnett Passe and Rodney Williams Memorial Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003354","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100004318","name":"Microsoft","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100004318","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["The Laryngoscope"],"published-print":{"date-parts":[[2024,12]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To evaluate a referral\u2010based, tele\u2010otology service in rural and remote areas of the Northern Territory, Australia.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>A retrospective observational cohort study was performed of a tele\u2010otology service in 93 Aboriginal and Torres Strait Islander communities (2011 to 2019). Assessments included face\u2010to\u2010face examinations performed by Clinical Nurse Consultants and audiologists, and asynchronous reviews performed by otolaryngologists. Multivariable logistic regression was performed to determine the likelihood of ear disease, adjusted for age and gender. Intra\u2010 and inter\u2010rater agreement was assessed between otolaryngologists.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>A total of 3,950 patients were reviewed (6,838 encounters, 13,726 ear assessments). The median age of patients was 9.8\u2009years (interquartile range: 7.2\u2009years). Overall, 62.2% of patients were identified with ear disease and 62.5% identified with hearing loss. Substantial intra\u2010 and inter\u2010rater agreement in diagnosis was found between otolaryngologists (<jats:italic>\u03ba<\/jats:italic>\u2009=\u20090.71 and <jats:italic>\u03ba<\/jats:italic>\u2009=\u20090.78, respectively). The most common ear conditions identified were chronic otitis media (COM, 28.1%) and otitis media with effusion (OME, 16.5%). Topical or oral antibiotics were initiated in 14.1% of all encounters, most often for acute otitis media or COM. Surgery was recommended in 27.7% of all encounters, most often myringoplasty, adenoidectomy, and myringotomy with insertion of tympanostomy tubes.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Tele\u2010otology is a critical component of an integrated approach to evaluating ear disease in Indigenous people living in rural and remote areas. The high prevalence of OME, COM, and surgical recommendations highlights the need for community engagement, regular follow\u2010up, and early interventions to prevent long\u2010term hearing loss.<\/jats:p><\/jats:sec><jats:sec><jats:title>Level of Evidence<\/jats:title><jats:p>NA <jats:italic>Laryngoscope<\/jats:italic>, 134:5096\u20135102, 2024<\/jats:p><\/jats:sec>","DOI":"10.1002\/lary.31624","type":"journal-article","created":{"date-parts":[[2024,7,10]],"date-time":"2024-07-10T07:25:23Z","timestamp":1720596323000},"page":"5096-5102","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":10,"title":["Tele\u2010otology for Aboriginal and Torres Strait Islander People Living in Rural and Remote Areas"],"prefix":"10.1002","volume":"134","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6327-4648","authenticated-orcid":false,"given":"Al\u2010Rahim","family":"Habib","sequence":"first","affiliation":[{"name":"Sydney Medical School, Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"},{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Royal Darwin Hospital, Top End Health Service, Department of Health  Tiwi Northern Territory Australia"},{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Westmead Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graeme","family":"Crossland","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Royal Darwin Hospital, Top End Health Service, Department of Health  Tiwi Northern Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Raymond","family":"Sacks","sequence":"additional","affiliation":[{"name":"Sydney Medical School, Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Narinder","family":"Singh","sequence":"additional","affiliation":[{"name":"Sydney Medical School, Faculty of Medicine and Health University of Sydney  Sydney New South Wales Australia"},{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Westmead Hospital  Sydney New South Wales Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hemi","family":"Patel","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology\u2014Head and Neck Surgery Royal Darwin Hospital, Top End Health Service, Department of Health  Tiwi Northern Territory Australia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2024,7,10]]},"reference":[{"key":"e_1_2_7_2_1","doi-asserted-by":"publisher","DOI":"10.1016\/S0165-5876(99)00156-1"},{"key":"e_1_2_7_3_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2431-5-27"},{"key":"e_1_2_7_4_1","unstructured":"World Health Organization.Child and Adolescent Health and Development Prevention of Blindness and Deafness. Chronic Suppurative Otitis Media: Burden of Illness and Management Options [Internet]. Geneva Switzerland.2004https:\/\/www.who.int\/pbd\/publications\/Chronicsuppurativeotitis_media.pdf"},{"key":"e_1_2_7_5_1","doi-asserted-by":"publisher","DOI":"10.1111\/1753-6405.12948"},{"key":"e_1_2_7_6_1","doi-asserted-by":"publisher","DOI":"10.1186\/s40352-019-0097-6"},{"key":"e_1_2_7_7_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471-2431-5-16"},{"key":"e_1_2_7_8_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.15044"},{"key":"e_1_2_7_9_1","unstructured":"Aihw.Hearing Health Outreach Services to Aboriginal and Torres Strait Islander Children and Young People in the Northern Territory: 2012\u201313 to 2014\u201315. Canberra.2015."},{"key":"e_1_2_7_10_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.2008.tb01715.x"},{"key":"e_1_2_7_11_1","doi-asserted-by":"publisher","DOI":"10.1089\/tmj.2010.0045"},{"issue":"1","key":"e_1_2_7_12_1","first-page":"26","article-title":"Otolaryngology consultations by real\u2010time telemedicine","volume":"71","author":"Ullah R","year":"2002","journal-title":"Ulster Med J"},{"key":"e_1_2_7_13_1","doi-asserted-by":"publisher","DOI":"10.1586\/17434440.4.1.5"},{"key":"e_1_2_7_14_1","first-page":"11","article-title":"Tele\u2010audiology services in Australia: a shift in clinical practices","volume":"81","author":"Bennett RJ","year":"2020","journal-title":"Audiol Now"},{"key":"e_1_2_7_15_1","doi-asserted-by":"publisher","DOI":"10.1258\/jtt.2012.gth114"},{"key":"e_1_2_7_16_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.2013.281053"},{"key":"e_1_2_7_17_1","doi-asserted-by":"publisher","DOI":"10.5694\/mja2.50953"},{"key":"e_1_2_7_18_1","doi-asserted-by":"publisher","DOI":"10.2307\/2529310"},{"key":"e_1_2_7_19_1","first-page":"1","article-title":"Technology acceptance in healthcare: a systematic review","volume":"11","author":"Alqudah AA","year":"2021","journal-title":"Appl Sci (Switzerland)"},{"key":"e_1_2_7_20_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-023-09338-2"},{"key":"e_1_2_7_21_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-023-10034-4"},{"key":"e_1_2_7_22_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12911-022-01952-0"},{"key":"e_1_2_7_23_1","doi-asserted-by":"publisher","DOI":"10.1186\/s13643-020-01349-y"},{"key":"e_1_2_7_24_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-023-09265-2"},{"key":"e_1_2_7_25_1","doi-asserted-by":"publisher","DOI":"10.1136\/bmjopen-2017-016242"},{"key":"e_1_2_7_26_1","doi-asserted-by":"publisher","DOI":"10.3390\/children10010165"},{"issue":"1","key":"e_1_2_7_27_1","first-page":"1","article-title":"The O.P.E.N. Survey: outreach projects in ear, nose and throat (ENT) in New South Wales. Australian","volume":"2","author":"Shein G","year":"2019","journal-title":"J Otolaryngol"},{"key":"e_1_2_7_28_1","doi-asserted-by":"publisher","DOI":"10.1186\/s12913-023-10152-z"},{"issue":"1","key":"e_1_2_7_29_1","article-title":"Otitis media in indigenous australian children: review of epidemiology and risk factors","volume":"128","author":"Jervis\u2010Bardy J","year":"2014","journal-title":"J Laryngol Otol"},{"key":"e_1_2_7_30_1","unstructured":"ForemanA.The Aetiology and Prevention of Otitis Media in Indigenous Children in the Northern Territory Australia. [Darwin Northern Territory]: University of Sydney.1987."},{"key":"e_1_2_7_31_1","doi-asserted-by":"publisher","DOI":"10.5694\/j.1326-5377.1988.tb104509.x"},{"key":"e_1_2_7_32_1","unstructured":"Australian Institute of Health and Welfare.Northern Territory Emergency Response Child Health Check Initiative: Follow\u2010up Services for Oral and ear Health. Canberra.2012."},{"key":"e_1_2_7_33_1","doi-asserted-by":"publisher","DOI":"10.3389\/fdgth.2021.788103"},{"key":"e_1_2_7_34_1","doi-asserted-by":"publisher","DOI":"10.1055\/s-0039-1677897"},{"key":"e_1_2_7_35_1","first-page":"102312","volume-title":"Artificial Intelligence in Medicine","author":"Sch\u00fcnke LC","year":"2022"},{"key":"e_1_2_7_36_1","doi-asserted-by":"publisher","DOI":"10.1097\/MAO.0000000000003484"},{"key":"e_1_2_7_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/coa.13925"},{"key":"e_1_2_7_38_1","doi-asserted-by":"publisher","DOI":"10.1177\/1357633X231158839"}],"container-title":["The Laryngoscope"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1002\/lary.31624","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,11,14]],"date-time":"2024-11-14T12:05:48Z","timestamp":1731585948000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1002\/lary.31624"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2024,7,10]]},"references-count":37,"journal-issue":{"issue":"12","published-print":{"date-parts":[[2024,12]]}},"alternative-id":["10.1002\/lary.31624"],"URL":"https:\/\/doi.org\/10.1002\/lary.31624","archive":["Portico"],"relation":{},"ISSN":["0023-852X","1531-4995"],"issn-type":[{"value":"0023-852X","type":"print"},{"value":"1531-4995","type":"electronic"}],"subject":[],"published":{"date-parts":[[2024,7,10]]},"assertion":[{"value":"2024-01-16","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-06-17","order":2,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2024-07-10","order":3,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}