Otitis Media Diagnosis for Developing Countries Using Tympanic Membrane Image-Analysis

Background Otitis media is one of the most common childhood diseases worldwide, but because of lack of doctors and health personnel in developing countries it is often misdiagnosed or not diagnosed at all. This may lead to serious, and life-threatening complications. There is, thus a need for an automated computer based image-analyzing system that could assist in making accurate otitis media diagnoses anywhere. Methods A method for automated diagnosis of otitis media is proposed. The method uses image-processing techniques to classify otitis media. The system is trained using high quality pre-assessed images of tympanic membranes, captured by digital video-otoscopes, and classifies undiagnosed images into five otitis media categories based on predefined signs. Several verification tests analyzed the classification capability of the method. Findings An accuracy of 80.6% was achieved for images taken with commercial video-otoscopes, while an accuracy of 78.7% was achieved for images captured on-site with a low cost custom-made video-otoscope. Interpretation The high accuracy of the proposed otitis media classification system compares well with the classification accuracy of general practitioners and pediatricians (~ 64% to 80%) using traditional otoscopes, and therefore holds promise for the future in making automated diagnosis of otitis media in medically underserved populations.

[1]  P. Morris,et al.  Chronic suppurative otitis media Burden of Illness and Management Options , 2004 .

[2]  J. Lous,et al.  Criteria, performance and diagnostic problems in diagnosing acute otitis media. , 1999, Family practice.

[3]  Bryan A. Smith,et al.  Hydraphiles: A Rigorously Studied Class of Synthetic Channel Compounds with In Vivo Activity , 2013, Int. J. Biomed. Imaging.

[4]  W. H. Bradley,et al.  1A. Definition and Classification , 1985 .

[5]  J. Ross Quinlan,et al.  Induction of Decision Trees , 1986, Machine Learning.

[6]  Federico Marchetti,et al.  Burden of Disease Caused by Otitis Media: Systematic Review and Global Estimates , 2012, PloS one.

[7]  S. Fanello,et al.  Clinical qualitative evaluation of the diagnosis of acute otitis media in general practice. , 2008, International journal of pediatric otorhinolaryngology.

[8]  M. Pichichero,et al.  Assessing diagnostic accuracy and tympanocentesis skills in the management of otitis media. , 2001, Archives of pediatrics & adolescent medicine.

[9]  Jelena Kovacevic,et al.  Automated Diagnosis of Otitis Media: Vocabulary and Grammar , 2013, Int. J. Biomed. Imaging.

[10]  Peter Norvig,et al.  Artificial Intelligence: A Modern Approach , 1995 .

[11]  M. Jacobs,et al.  Survey of ENT services in Africa: need for a comprehensive intervention , 2009, Global health action.

[12]  S. R. Rood,et al.  Prenatal Development of the Eustachian Tube , 1985 .

[13]  A. Adamo,et al.  Definition and classification , 1996, European Journal of Orthopaedic Surgery & Traumatology.

[14]  Haim Reuveni,et al.  Accuracy of acute otitis media diagnosis in community and hospital settings , 2005, Acta paediatrica.

[15]  Mohammed K. Ali,et al.  The United States and global health: inseparable and synergistic? The Institute of Medicine's report on global health , 2009, Global health action.

[16]  Dan J Stein,et al.  Global, regional, and national incidence, prevalence, and years lived with disability for 301 acute and chronic diseases and injuries in 188 countries, 1990–2013: a systematic analysis for the Global Burden of Disease Study 2013 , 2015, The Lancet.

[17]  D. James,et al.  Definition and classification , 1994 .

[18]  Anne Pitkäranta,et al.  Is it possible to diagnose acute otitis media accurately in primary health care? , 2003, Family practice.

[19]  R. Rosenfeld,et al.  The diagnosis and management of acute otitis media. , 2013, Pediatrics.

[20]  David D Pothier,et al.  Recognition of paediatric otopathology by General Practitioners. , 2008, International journal of pediatric otorhinolaryngology.