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Li LYJ, Wang SY, Yang JM, Chen CJ, Tsai CY, Wu LYY, Wu TF, Wu CJ. The Development and Evaluation of a Smartphone-Aided Diagnosis Application to Measure Tympanic Membrane Perforations. Ear Nose Throat J 2022:1455613221123361. [PMID: 35993670 DOI: 10.1177/01455613221123361] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
OBJECTIVES Chronic otitis media is a long-term infection of the middle ear. It is characterized by persistent discharge from the middle ear through a perforated tympanic membrane. It is one of the most common causes of preventable hearing loss, especially in developing countries. Precise estimation of the size of tympanic membrane perforation is essential for successful clinical management. In this study, we developed a smartphone-based application to calculate the ratio of the area of tympanic membrane perforation to the area of the tympanic membrane. Twelve standardized patients and 60 medical students were involved to assess the area of tympanic membrane perforation, in particular, the percentage of perforation size. METHODS In total, 60 student doctors (including year 5 and year 6 medical students, intern and post-graduate year training of doctors) were recruited during their rotation at the Otolaryngology department of Taipei Medical University Shuang-Ho Hospital. Twelve standardized patients with chronic otitis media were recruited through a single otology practice. Oto-endoscopic examination was performed for all patients by using a commercially-available digital oto-endoscope, and clinical images of the tympanic membrane perforation were obtained. To demonstrate the variability of perforation size estimation by different student doctors, we calculated the percentage of perforation using the smartphone-based application for 12 tympanic membranes objectively and compared the results with those visually estimated by the 60 student doctors subjectively. RESULTS The variance in the visual estimation by the 60 student doctors was large. By contrast, variances in smartphone-based application calculations were smaller, indicating consistency in the results obtained from different users. The smartphone-based application accurately estimated the presence of perforation for tympanic membranes with high consistency. The differences in visual estimations can be considerably great and the variances can be large among different individuals. CONCLUSIONS The smartphone-based application is a dependable tool for precisely evaluating the size of tympanic membrane perforation.
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Affiliation(s)
- Lok-Yee Joyce Li
- Department of Anatomical Pathology, Far Eastern Memorial Hospital, Taipei, Taiwan
- Department of Medicine, Shin Kong Wu-Ho-Su Memorial Hospital, Taipei, Taiwan
- Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Shin-Yi Wang
- Department of Nursing, National Taiwan University Hospital Hsinchu Branch, Hsinchu, Taiwan
| | - Jinn-Moon Yang
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu, Taiwan
| | - Chih-Jou Chen
- Master Program in School of Nursing, Taipei Medical University, Taipei, Taiwan
| | - Cheng-Yu Tsai
- Department of Civil and Environmental Engineering, Imperial College London, London, UK
| | - Lucas Yee-Yan Wu
- Department of Medicine, Shin Kong Wu-Ho-Su Memorial Hospital, Taipei, Taiwan
- Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
| | - Te-Fang Wu
- Department of Otolaryngology - Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung, Taiwan
| | - Cheng-Jung Wu
- Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei, Taiwan
- Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, Taipei, Taiwan
- PhD Degree Program in Biomedical Science and Engineering, National Yang Ming Chiao Tung University, Hsinchu, Taiwan
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Li LYJ, Wang SY, Yang JM, Chen CJ, Tsai CY, Wu LYY, Wu TF, Wu CJ. Validation of a Personalized Hearing Screening Mobile Health Application for Persons with Moderate Hearing Impairment. J Pers Med 2021; 11:jpm11101035. [PMID: 34683176 PMCID: PMC8538050 DOI: 10.3390/jpm11101035] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/23/2021] [Revised: 10/11/2021] [Accepted: 10/13/2021] [Indexed: 11/21/2022] Open
Abstract
Hearing impairment is a frequent human sensory impairment. It was estimated that over 50% of those aged >75 years experience hearing impairment in the United States. Several hearing impairment–related factors are detectable through screening; thus, further deterioration can be avoided. Early identification of hearing impairment is the key to effective management. However, hearing screening resources are scarce or inaccessible, underlining the importance of developing user-friendly mobile health care systems for universal hearing screening. Mobile health (mHealth) applications (apps) act as platforms for personalized hearing screening to evaluate an individual’s risk of developing hearing impairment. We aimed to evaluate and compare the accuracy of smartphone-based air conduction and bone conduction audiometry self-tests with that of standard air conduction and bone conduction pure-tone audiometry tests. Moreover, we evaluated the use of smartphone-based air conduction and bone conduction audiometry self-tests in conductive hearing loss diagnosis. We recruited 103 patients (206 ears) from an otology clinic. All patients were aged ≥20 years. Patients who were diagnosed with active otorrhea was excluded. Moderate hearing impairment was defined as hearing loss with mean hearing thresholds >40 dB. All patients underwent four hearing tests performed by a board-certified audiologist: a smartphone-based air conduction audiometry self-test, smartphone-based bone conduction audiometry self-test, standard air-conduction pure-tone audiometry, and standard bone conduction pure-tone audiometry. We compared and analyzed the results of the smartphone-based air conduction and bone conduction audiometry self-tests with those of the standard air conduction and bone conduction pure-tone audiometry tests. The sensitivity of the smartphone-based air conduction audiometry self-test was 0.80 (95% confidence interval CI = 0.71–0.88) and its specificity was 0.84 (95% CI = 0.76–0.90), respectively. The sensitivity of the smartphone-based bone conduction audiometry self-test was 0.64 (95% CI = 0.53–0.75) and its specificity was 0.71 (95% CI = 0.62–0.78). Among all the ears, 24 were diagnosed with conductive hearing loss. The smartphone-based audiometry self-tests correctly diagnosed conductive hearing loss in 17 of those ears. The personalized smartphone-based audiometry self-tests correctly diagnosed hearing loss with high sensitivity and high specificity, and they can be a reliable screening test to rule out moderate hearing impairment among the population. It provided patients with moderate hearing impairment with personalized strategies for symptomatic control and facilitated individual case management for medical practitioners.
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Affiliation(s)
- Lok-Yee Joyce Li
- Department of Medicine, Shin Kong Wu-Ho-Su Memorial Hospital, Taipei 111, Taiwan;
- School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan;
- Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
- Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, New Taipei 23561, Taiwan
| | - Shin-Yi Wang
- Department of Nursing, National Taiwan University Hospital, Hsinchu Branch, Hsinchu 300, Taiwan;
| | - Jinn-Moon Yang
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan;
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu 300, Taiwan
| | - Chih-Jou Chen
- Master Program in School of Nursing, Taipei Medical University, Taipei 110, Taiwan;
| | - Cheng-Yu Tsai
- Department of Civil and Environmental Engineering, Imperial College London, London SW7 2BT, UK;
| | - Lucas Yee-Yan Wu
- School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan;
- Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
- Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, New Taipei 23561, Taiwan
| | - Te-Fang Wu
- Department of Otolaryngology—Head and Neck Surgery, Kaohsiung Veterans General Hospital, Kaohsiung 813, Taiwan;
| | - Cheng-Jung Wu
- School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan;
- Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
- Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, New Taipei 23561, Taiwan
- Ph.D. Degree Program in Biomedical Science and Engineering, National Yang Ming Chiao Tung University, Hsinchu 300, Taiwan
- Correspondence:
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Li LYJ, Wang SY, Yang JM, Chen CJ, Tsai CY, Wu LYY, Wu CJ. Can Face- and Smartphone-Touching Behaviors Be Altered with Personal Hygiene Reminders during the COVID-19 Pandemic Period? An Observational Study. Int J Environ Res Public Health 2021; 18:ijerph181910038. [PMID: 34639340 PMCID: PMC8507970 DOI: 10.3390/ijerph181910038] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Revised: 09/06/2021] [Accepted: 09/13/2021] [Indexed: 11/16/2022]
Abstract
As part of the new measures to prevent the spread of the 2019 coronavirus disease (COVID-19), medical students were advised to wear a mask in class and avoid touching their faces. Few studies have analyzed the influence of health education on the frequency of face- and smartphone-touching behaviors during the COVID-19 pandemic. This research compared the frequency of in-class face- and smartphone-touching behaviors of medical students before and after the delivery of personal hygiene education during the COVID-19 pandemic. A behavioral observational study was conducted involving medical students at Taipei Medical University. Eighty medical students were recruited during a lecture on otorhinolaryngology. All medical students were required to wear a mask. Their face- and smartphone-touching behavior was observed by viewing the 4 k resolution video tape recorded in class. The recording lasted for 2 h, comprising 1 h prior to the health educational reminder and 1 h afterwards. The frequencies of hand-to-face contact and hand-to-smartphone contact were analyzed before and after the delivery of health education emphasizing personal hygiene. Comprehensive health education and reminders effectively reduce the rate of face- and smartphone-touching behaviors.
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Affiliation(s)
- Lok-Yee Joyce Li
- Department of Medicine, Shin Kong Wu-Ho-Su Memorial Hospital, Taipei 111, Taiwan;
- School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan;
- Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
- Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, New Taipei 23561, Taiwan
| | - Shin-Yi Wang
- National Taiwan University Hospital, Hsinchu Branch, Hsinchu 300, Taiwan;
| | - Jinn-Moon Yang
- Institute of Bioinformatics and Systems Biology, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan;
- Department of Biological Science and Technology, National Chiao Tung University, Hsinchu 30010, Taiwan
| | - Chih-Jou Chen
- Master Program in School of Nursing, Taipei Medical University, Taipei 111, Taiwan;
| | - Cheng-Yu Tsai
- Department of Civil and Environmental Engineering, Imperial College London, London SW7 2BT, UK;
| | - Lucas Yee-Yan Wu
- School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan;
- Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
- Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, New Taipei 23561, Taiwan
- Ph.D. Degree Program in Biomedical Science and Engineering, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
| | - Cheng-Jung Wu
- School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan;
- Department of Otolaryngology, School of Medicine, College of Medicine, Taipei Medical University, Taipei 110, Taiwan
- Department of Otolaryngology, Shuang Ho Hospital, Taipei Medical University, New Taipei 23561, Taiwan
- Ph.D. Degree Program in Biomedical Science and Engineering, National Yang Ming Chiao Tung University, Hsinchu 30010, Taiwan
- Correspondence:
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