Validation of a Low-Cost Method for Recording and Supervising Otolaryngology Trainee Endoscopies.

Abstract

Objectives/hypothesis: To design low-cost smartphone adapters for recording otolaryngology trainee and physician extender endoscopies and evaluate their image quality and usability in the inpatient and emergency room (ER) settings.

Study design: Prospective mixed-methods study, including device design, quantitative, and qualitative surveys.

Methods: 3D-printed adapters for rigid and flexible fiberoptic endoscopy were iteratively developed. Three versions of the adapters were provided to otolaryngology trainees, faculty, and physician extenders: phone adapters +/- telescope magnification and tablet/laptop adapters featuring a universal serial bus camera. Surveys including the System Usability Scale (SUS) and questions on image quality, ease of use, and impact on patient care were administered. Images from the adapters and existing recording methods were compared using the Blind/Referenceless Image Spatial Quality Evaluator (BRISQUE) image quality metric.

Results: 20 otolaryngology staff completed the survey (nine residents, one physician assistant, nine attendings, one fellow). SUS scores were excellent with a mean of 77.5 (SD 9.7). There were no significant differences in BRISQUE scores when comparing the smartphone adapters with single-use distal-chip nasopharyngolaryngoscopes and clinic fiberoptic systems (F = 0.7, df = 4, P = 0.5890). The cost to fabricate the phone adapter with/without a telescope and the tablet/laptop adapter was $1.28, $39.38, and $93.84, respectively. Responses to semi-structured questions highlighted positive impact on supervision and collaboration.

Conclusions: There are limited options for recording and supervising otolaryngology trainee endoscopic exams in the inpatient and ER settings. Endoscopic phone adapters designed by 3D printing can generate sufficient image quality and usability for clinical supervision.