DIY diagnosis for ear infections: There may soon be an application for this: Shots

The researchers are developing a smartphone app that, with the help of a simple paper funnel, could help parents detect a build-up of fluid in a child's ear – the # 39, one of the symptoms of an ear infection.

The application is still experimental and would require authorization from the Food and Drug Administration before it can be marketed. But the first data, published Wednesday in Translational medicine science, suggests that the smartphone can perform as well as an expensive test in a doctor's office.

Although there are several thousand health-related apps, this one stands out by the fact that she uses the phone's microphone and speaker to establish her diagnosis.

"All you really need to do to detect ear fluid is the use of sound," says Justin Chan, a graduate student of the School of Engineering and Engineering. Paul G. Allen Computer from the University of Washington in Seattle.

To focus this sound, doctors and parents made a small paper funnel. The tip of the funnel inserts into the auditory canal. The application then sends short sounding pulses "a bit like a chirping bird" in the ear, explains Chan.

The funnel picks up the echo of this sound and then analyzes the application. If there is fluid behind the eardrum, the echoes will be different from those of a healthy ear. An algorithm on the phone detects it almost instantly.

Chan uses a glass of wine as an analogy. "If a glass of wine is empty or half full, tapping on it will produce a different sound," he says. "And that's exactly what we do with our tool."

Chan is the principal author of a study that was attended by other researchers, including his close associate, Dr. Sharat Raju, of the University of Washington and the Seattle Children & # 39; s Hospital and Research Institute.

About 50 children had their ears checked with the application. Some of these children then underwent planned surgery on their eardrums, which allowed the doctors to check the results of the application. Scientists have reported that this was true about 85% of the time, which is comparable to the technology currently used in otolaryngology clinics.

Chan and his colleagues have created a company to develop the application as a commercial product. He says that they are asking the FDA to kindly market it. The agency would need additional studies to evaluate the performance and reliability of the application, but he hopes the group will be able to collect this data by the end of the year .

"It's very promising, but it's too early to say how accurate that is," said Dr. Kenny Chan, head of the Pediatric Otolaryngology Department at the University of Toronto. 39, Colorado Children's Hospital, based on recently published data. "We will have to wait and see."

A big question is, how useful will this be for parents and doctors?

A fluid behind the eardrum is a symptom of ear infection, but "all the fluid is not an infection," says Pamela Mudd, a specialist in the ears, nose and throat of the National Children's Health System in Washington, DC "It would be more of a test for [see if] behind the eardrum, something happens that could affect my child, "rather than diagnose an ear infection.

Doctors really need to examine a child to ask this diagnosis, which is based on the examination of the ear, temperature and other clinical signs, she said.

Mucus and other mild fluids can accumulate behind the eardrum and not cause infection, she says. When she examines the ear of a child and she does not see it, she directs it to a clinic where doctors use an instrument called a tympanometer, which measures the fluid located behind the tympanum using sound waves.

At the same time, the audiology clinic often checks for hearing loss, which helps guide treatment decisions, for example if a child would benefit from tubes to drain the accumulated fluid.

Assuming the application is effective, says Mudd, she would like to talk to parents about how to interpret the results before recommending them to buy it.

"They may not know that they have to understand what the devices tell them," she says. The developers suggest that the app can help parents avoid going to the doctor, but Mudd says the opposite may be the case.

"This could increase our use of the health care system" if parents took their children to the doctor for what might be a little temporary fluid behind the eardrum. There may be cases where this is appropriate, she says.

Chan, the otolaryngologist in Colorado, is also concerned about this situation. "To speculate on the fact that this could replace the need for a visit to the doctor, I think it's a little far-fetched," he says.

Doctors have encountered this problem after Apple released a watch to identify irregular heartbeats, notes Oliver Aalami, a vascular surgeon at Stanford University, who is also studying mobile health applications.

"At first, there was a lot of hype, but if you talk to cardiologists, they are very worried," he says, because the doctors have suddenly been confronted with a lot of worried patients, and he's not sure what to do. was not clear if all these new doctor appointments and interventions with medications and tests were helpful.

As a result of these concerns, Apple is currently conducting a large follow-up study to measure the benefits and risks of the application. Assuming that the eardrum application gets clearance from the FDA, Aalami thinks that a similar study might be needed to determine if the application is actually beneficial.

In reading the research paper, his first impression was that the application would be more useful in a medical office, both in the United States and in parts of the world that have fewer medical resources. "It may be a bit too advanced for home use," he says.

But the inventors are targeting a home market. "I see it very like a thermometer, where if you think your child has the flu or cold, you check their temperature several times a day," says Justin Chan. "We think this has a similar purpose."

He added that the developers had not yet set a price, but they wanted the application to be widely available, especially in developing countries, so that its price would be calculated accordingly.

For this young computer scientist, this project could be an exciting start to his career. "I know it's something that can touch millions of lives," he says. "And I think it's pretty rare in research."

You can contact NPR Scientific Correspondent Richard Harris at [email protected].