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Wondering if your child has an ear infection? According to researchers at the University of Washington, there will soon be an application for this. They claim to have created a simple test that uses a smartphone and folded paper to detect one of the tell-tale signs of infection – a liquid in the ears – with an accuracy equal to or greater than that of a patient. doctor.
Ear infections are one of the first health problems that people tend to experience. By the age of three, almost everyone had at least one ear infection. These infections often cause an accumulation of fluid in the ear, just like another condition called otitis media with effusion (OME). But although most infections or cases of OMA go away on their own, too much fluid or chronic fluids can cause pain or even serious complications like hearing loss.
There are already very accurate tests (about 80 to 90%) that can be used to diagnose the ear fluid by looking for subtle changes to the eardrum, such as tympanometry, but they need to be done at the doctor's office and require specialized medical equipment. Thus, the authors of this study, published Wednesday in Science Translational Medicine, wanted to create a test easy to use and inexpensive, able to compete with this precision.
"If this app can give doctors a specialist level accuracy, it could really change the way ear infections are handled globally."
Their test consists of an application called EarHealth, which emits chirped sounds, which are routed into the auditory canal by a piece of folded paper glued to the phone and placed on the outer ear. These sound waves bounce from the middle ear to the phone and, along the way, they interact with the sounds being played. The cacophony of the reflected sound is then detected by the microphone of the phone, where it is analyzed by the application. Finally, the application, based on the fluctuations of the signal that it receives, predicts the chances of fluid in the ear.
"It's a bit like beating a glass of wine," co-lead author Justin Chan, a PhD student at the Paul G. Allen School of Computer Science and Engineering at the University of Washington, told Gizmodo by phone. "Depending on whether the glass is empty or half full, you will get a different sound. So, it's the same principle here. "
Mr. Chan and his team first tested the concept with children 18 months to 17 years admitted to the Seattle Children's Hospital and used them to refine the predictive algorithm of the application. Half of the children had to undergo surgery that could treat the chronic accumulation of fluid in their ear by inserting small hollow tubes, while the other half would undergo interventions unrelated to their ears. The design of the study was an infallible test of the accuracy of the application.
"It is not really easy for existing screening tools to detect fluid in the middle ear. In reality, the only way to know, with absolute certainty, is to undergo surgery during which an incision is made in the eardrum, where it can drain the fluid. So, once you make this incision, you can know for sure if there is liquid or not, "explained Chan.
In this initial study, the application could predict whether a person had an ear fluid with an accuracy of 85% and correctly if it had no fluid with an accuracy of 80%.
Since babies are at greatest risk of ear infection (and are less likely to be able to express their discomfort when they feel sick), the improved application has then tested with 15 children aged 9 to 18 months. This time, the application correctly identified the 5 children who had ear fluid, while correctly guessing nine of the 10 children who had no fluid.
Finally, in another experiment, Chan's team asked her parents to use the app on 25 ears, following a brief tutorial. The accuracy remained as high as before and the readings obtained by the parents closely matched those obtained by the doctors when using the application. This suggests that parents will not have much difficulty using the app outside of the medical setting. Above all, during all these trials, the children did not seem too upset to have to hold a telephone funnel in their ear.
"The chirps are actually pretty soft. And interestingly, when we hit the children's ears in the hospital, we found that they were responding with smiles or laughs. Tweets have a calming effect, "said Chan.
Ideally, the app could be used as a home diagnostic tool by worried parents as the pull of their child's ear is no longer serious. This would allow their children to avoid unnecessary visits to the doctor or to get the follow-up care they may need. But Chan also considers that doctors from less developed regions use the app as a screening tool, the application being more accurate than a simple visual inspection of the ears by a doctor. Adding to the potential of the app, it was able to run on iPhone and Android phone models, as well as on different types of paper for the funnel.
"Even in developing countries, smartphones are becoming more prevalent. So, if this app can give doctors a specialist level accuracy, it could really change the way ear infections are handled globally, "Chan said.
Chan and his co-authors founded a company called Edus Health, responsible for marketing the application. He told Gizmodo that they hoped the application as a medical device would be approved by the Food and Drug Administration by the end of the year; it would then be widely available to the American public. The company is also collaborating with doctors from developing countries, hoping that the application will soon be widely used in these countries.
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