Digital versus traditional otoscopy in the diagnosis of acute otitis media in the pediatric primary care clinic

Objectives

Our objective was to assess whether the use of digital otoscopy versus traditional otoscopy in a pediatric clinic setting leads to decreased rates of antibiotic prescriptions and follow-up visits. Secondary outcomes included photo viability and both patient and provider satisfaction.

Methods

This was a prospective study in which both digital otoscopes and traditional otoscopes were deployed at two different pediatric offices during an eight-week pilot period. The treatment group consisted of 35 patients who received ear exams with digital otoscopy while the control group consisted of 586 patients who received ear exams with traditional otoscopy. Measured outcomes included rates of antibiotic prescription and follow-up visits, photo viability, and both patient and provider satisfaction.

Results

Comparing the treatment group with the control group, the average number of visits per patient decreased by 0.14 from 1.14 to 1.0, (p = 0.007). The number of antibiotic prescriptions per patient decreased by 0.31 from 0.88 to 0.57 (p = 0.0008). The overall experience with digital otoscopy was rated as good or excellent in 94 % (16/17) of patients. Seventy-three percent (8/11) of providers rated the digital otoscope as excellent or good compared to traditional otoscopes, and 82 % (9/11) stated that they were extremely likely or likely to continue using the digital otoscope in their practice.

Conclusion

The use of digital otoscopy versus traditional otoscopy in a pediatric clinic setting was associated with significant decreases in follow-up visit volumes as well antibiotic prescriptions. Implementing digital otoscopy more widely may contribute to decreased healthcare utilization costs and improved antibiotic stewardship for acute otitis media.