Accuracy of pre-recorded video images for the assessment of rural indigenous children with ear, nose and throat conditions

Abstract

We compared the accuracy of ear, nose and throat (ENT) assessments made by a specialist in the conventional face-to-face (FTF) manner with assessments made using pre-recorded information, i.e. history and video recording of the ears, nose, face and throat. 58 patients, mainly of indigenous background, agreed to participate in the study (median age 6 years, interquartile range 4-8). They were assessed FTF by a specialist and then at least two months later were assessed by the same specialist on the basis of video clips and history recorded by a research nurse. A consensus panel of otolaryngologists compared the diagnosis and management from the original face-to-face appointment and the review of the pre-recorded material. Of the 58 assessments, the diagnosis was the same in 47 cases (81%). Where differences in opinion occurred, four were considered to be related to the quality of baseline history and seven were thought to be related to the examination. Decisions related to clinical management (including treatment) were identical in 44 cases (76%). Where differences were identified, six were related to quality of history and seven associated with the examination. When intra-observer agreement was measured, there were variations in up to 10% of cases which may explain some of the discrepancies in the cases reviewed. The study confirms that pre-recorded video images are useful for the assessment of common ENT conditions. It also demonstrates the potential of a telemedicine application for the early detection and monitoring of indigenous children at high risk of developing chronic diseases that cause hearing loss.