{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T15:32:40Z","timestamp":1788276760436,"version":"build-2803163510"},"reference-count":10,"publisher":"SAGE Publications","issue":"7","license":[{"start":{"date-parts":[[2017,5,8]],"date-time":"2017-05-08T00:00:00Z","timestamp":1494201600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["J Telemed Telecare"],"published-print":{"date-parts":[[2018,8]]},"abstract":"\n Introduction<\/jats:title>\n With the growing popularity of telemedicine and tele-diagnostics, clinical validation of new devices is essential. This study sought to investigate whether high-definition digital still images of the eardrum provide sufficient information to make a correct diagnosis, as compared with the gold standard view provided by clinical microscopy.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n Twelve fellowship-trained ear physicians (neurotologists) reviewed the same set of 210 digital otoscope eardrum images. Participants diagnosed each image as normal or, if abnormal, they selected from seven types of ear pathology. Diagnostic percentage correct for each pathology was compared with a gold standard of diagnosis using clinical microscopy with adjunct audiometry and\/or tympanometry. Participants also rated their degree of confidence for each diagnosis.<\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n Overall correctness of diagnosis for ear pathologies ranged from 48.6\u2013100%, depending on the type of pathology. Neurotologists were 72% correct in identifying eardrums as normal. Reviewers\u2019 confidence in diagnosis varied substantially among types of pathology, as well as among participants.<\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n High-definition digital still images of eardrums provided sufficient information for neurotologists to make correct diagnoses for some pathologies. However, some diagnoses, such as middle ear effusion, were more difficult to diagnose when based only on a still image. Levels of confidence of reviewers did not generally correlate with diagnostic ability.<\/jats:p>\n <\/jats:sec>","DOI":"10.1177\/1357633x17708531","type":"journal-article","created":{"date-parts":[[2017,5,8]],"date-time":"2017-05-08T08:05:56Z","timestamp":1494230756000},"page":"453-459","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":51,"title":["Digital otoscopy versus microscopy: How correct and confident are ear experts in their diagnoses?"],"prefix":"10.1177","volume":"24","author":[{"given":"Aaron C","family":"Moberly","sequence":"first","affiliation":[{"name":"Department of Otolaryngology, The Ohio State University Wexner Medical Center, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Margaret","family":"Zhang","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, The Ohio State University Wexner Medical Center, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lianbo","family":"Yu","sequence":"additional","affiliation":[{"name":"Center for Biostatistics, The Ohio State University, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Metin","family":"Gurcan","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, The Ohio State University, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Caglar","family":"Senaras","sequence":"additional","affiliation":[{"name":"Department of Biomedical Engineering, The Ohio State University, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Theodoros N","family":"Teknos","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, The Ohio State University Wexner Medical Center, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles A","family":"Elmaraghy","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, The Ohio State University Wexner Medical Center, USA"},{"name":"Department of Pediatric Otolaryngology, Nationwide Children\u2019s Hospital, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nazhat","family":"Taj-Schaal","sequence":"additional","affiliation":[{"name":"Department of Internal Medicine, The Ohio State University Wexner Medical Center, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Garth F","family":"Essig","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology, The Ohio State University Wexner Medical Center, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2017,5,8]]},"reference":[{"key":"bibr1-1357633X17708531","doi-asserted-by":"publisher","DOI":"10.1053\/ajot.2002.28770"},{"key":"bibr2-1357633X17708531","doi-asserted-by":"publisher","DOI":"10.1002\/lary.24682"},{"key":"bibr3-1357633X17708531","doi-asserted-by":"publisher","DOI":"10.1007\/s00405-008-0839-x"},{"key":"bibr4-1357633X17708531","doi-asserted-by":"crossref","unstructured":"Moshtaghi O, Sahyouni R, Haidar YM, et al. Smartphone-enabled otoscopy in neurotology\/otology.\n Otolaryngology-Head and Neck Surgery\n 2017; 156: 554\u2013558.","DOI":"10.1177\/0194599816687740"},{"key":"bibr5-1357633X17708531","doi-asserted-by":"publisher","DOI":"10.1177\/0009922815593909"},{"key":"bibr6-1357633X17708531","doi-asserted-by":"publisher","DOI":"10.3928\/00904481-20131122-05"},{"key":"bibr7-1357633X17708531","doi-asserted-by":"crossref","unstructured":"Block SL. Diagnosing acute otitis media: It's what you see, not what you hear.\n Postgrad Med\n 2005; 118(Suppl Emerging): 5\u201312, 32\u201333.","DOI":"10.3810\/pgm.2005.12.suppl42.215"},{"key":"bibr8-1357633X17708531","doi-asserted-by":"crossref","unstructured":"Fleiss JL. Measuring nominal scale agreement among many raters.\n Psychol Bull\n 1971; 76: 378\u2013382.","DOI":"10.1037\/h0031619"},{"key":"bibr9-1357633X17708531","doi-asserted-by":"publisher","DOI":"10.1016\/j.ijporl.2004.10.013"},{"key":"bibr10-1357633X17708531","doi-asserted-by":"crossref","unstructured":"Senaras C, Moberly AC, Teknos T, et al. Autoscope: Automated otoscopy image analysis to diagnose ear pathology and use of clinically motivated eardrum features. In: Armato SG and Petrick NA (eds)\n Proceedings of SPIE\n , Orlando, FL, 3 March 2017, pp.101341X1\u2013101341X8. Bellingham, WA: SPIE; SPIE Medical Imaging.","DOI":"10.1117\/12.2250592"}],"container-title":["Journal of Telemedicine and Telecare"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1357633X17708531","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1177\/1357633X17708531","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1177\/1357633X17708531","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,2]],"date-time":"2026-05-02T03:11:43Z","timestamp":1777691503000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1177\/1357633X17708531"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2017,5,8]]},"references-count":10,"journal-issue":{"issue":"7","published-print":{"date-parts":[[2018,8]]}},"alternative-id":["10.1177\/1357633X17708531"],"URL":"https:\/\/doi.org\/10.1177\/1357633x17708531","relation":{},"ISSN":["1357-633X","1758-1109"],"issn-type":[{"value":"1357-633X","type":"print"},{"value":"1758-1109","type":"electronic"}],"subject":[],"published":{"date-parts":[[2017,5,8]]}}}