{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,2,7]],"date-time":"2026-02-07T22:55:27Z","timestamp":1770504927705,"version":"3.49.0"},"reference-count":14,"publisher":"Wiley","issue":"1","license":[{"start":{"date-parts":[[2008,7,1]],"date-time":"2008-07-01T00:00:00Z","timestamp":1214870400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["aao-hnsfjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Otolaryngol.--head neck surg."],"published-print":{"date-parts":[[2008,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine if video otoscope still images of the tympanic membrane taken in remote clinics are comparable to an in\u2010person microscopic examination for follow\u2010up care.<\/jats:p><\/jats:sec><jats:sec><jats:title>Design<\/jats:title><jats:p>Comparative concordance, diagnostic reliability.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>Community health aide\/practitioners in remote Alaska imaged 70 ears following tympanostomy tube placement. The patients were then examined in person by two otolaryngologists. Images were later reviewed at 8 and 14 weeks.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Intraprovider concordance for physical examination findings was: \u201cTube in,\u201d 94 percent\u201097 percent (\u03ba = 0.89\u20100.94); \u201cTube patent,\u201d 94 percent \u221297 percent (\u03ba = 0.89\u20100.94); \u201cDrainage,\u201d 90 percent\u201096 percent (\u03ba = \u20130.04\u20100.38); \u201cPerforation,\u201d 90 percent \u221296 percent (\u03ba = 0.61\u20100.82); \u201cGranulation,\u201d 97 percent \u2212100 percent (\u03ba = 0.49\u20101.0); \u201cMiddle ear fluid,\u201d 88 percent \u221296 percent (\u03ba = 0.28\u20100.71); \u201cRetracted,\u201d 83 percent\u201091 percent (\u03ba = 0.26\u20100.58). These agreement rates are similar to interprovider concordance when two otolaryngologists examine the same patient in person. Intraprovider concordance for diagnoses was 76 percent \u221280 percent (\u03ba = 0.64\u20100.71) and 77 percent \u221288 percent (\u03ba = 0.66\u20100.81) when poor images were excluded. Interprovider diagnostic concordance for the in\u2010person exam was 89 percent (\u03ba = 0.83).<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Video\u2010otoscopy images of the tympanic membrane are comparable to an in\u2010person examination for assessment and treatment of patients following tympanostomy tubes. Store\u2010and\u2010forward telemedicine is an acceptable method of following patients post tympanostomy tube placement.<\/jats:p><\/jats:sec>","DOI":"10.1016\/j.otohns.2008.04.008","type":"journal-article","created":{"date-parts":[[2008,6,28]],"date-time":"2008-06-28T05:10:22Z","timestamp":1214629822000},"page":"87-93","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":64,"title":["Digital images for postsurgical follow\u2010up of tympanostomy tubes in remote Alaska"],"prefix":"10.1002","volume":"139","author":[{"given":"John","family":"Kokesh","sequence":"first","affiliation":[{"name":"Alaska Native Medical Center Otolaryngology Anchorage AK"}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"A. 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