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Telehealth for primary health care ear disorders : a study in video-otoscopy
Thesis (DPhil)--University of Pretoria, 2015.
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| Format: | Thesis |
| Language: | English |
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University of Pretoria
2015
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| _version_ | 1867613576778219520 |
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| access_status_str | Open Access |
| author2 | Swanepoel, De Wet |
| author_browse | Swanepoel, De Wet |
| author_facet | Swanepoel, De Wet |
| collection | Thesis |
| dc_rights_str_mv | © 2015 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria. |
| description | Thesis (DPhil)--University of Pretoria, 2015. |
| format | Thesis |
| id | oai:repository.up.ac.za:2263/43101 |
| institution | University of Pretoria (South Africa) |
| language | English |
| last_indexed | 2026-06-10T12:38:21.029Z |
| license_str | Other — see source repository |
| provenance_str_mv | Harvested via OAI-PMH from UPSpace — University of Pretoria Institutional Repository |
| publishDate | 2015 |
| publishDateRange | 2015 |
| publishDateSort | 2015 |
| publisher | University of Pretoria |
| publisherStr | University of Pretoria |
| record_format | dspace |
| source_str | UPSpace — University of Pretoria Institutional Repository |
| spelling | oai:repository.up.ac.za:2263/43101 Telehealth for primary health care ear disorders : a study in video-otoscopy Swanepoel, De Wet Laurent, Claude Biagio-de Jager, Leigh Audiology Telehealth Otitis Media Primary health care (PHC) UCTD Thesis (DPhil)--University of Pretoria, 2015. The study examined the effectiveness of asynchronous video-otoscopy by a telehealth facilitator, for diagnosing ear disease in an underserved community at a primary health care clinic. Study I explored whether video-otoscopy images by a facilitator provided accurate asynchronous diagnosis. Onsite otoscopy was performed by an otolaryngologist on 61 adults. Video-otoscopy images were taken by the facilitator with no formal health care training, and by the otolaryngologist. Images were uploaded to secure server from which the otolaryngologist rated and made a diagnosis six weeks later. More otolaryngologist acquired images (83.6%) were graded as acceptable or better than facilitator images (75.4%). Moderate concordance was measured between asynchronous diagnosis from video-otoscopy images acquired by the otolaryngologist and facilitator (κ = 0.596). Lack of depth perception was considered a limitation of video-otoscopy images. Study II investigated asynchronous video-otoscopy recordings made by a facilitator in children at primary health care. Onsite otomicroscopy of 140 children (2-16 years) by an otologist was the gold standard. Video-otoscopy recordings were completed by a facilitator. Four and eight weeks later, an otologist and general practitioner asynchronously graded and made a diagnosis from online recordings. Video-otoscopy recording quality was acceptable or better in 87% of cases. Asynchronous diagnosis from recordings was not possible for 18% of ears. There was substantial agreement between asynchronous video-otoscopy and onsite diagnoses (κ = 0.679-0.745). Variability of asynchronous diagnosis accuracy was similar to inter- and intra-rater diagnostic variability. Study III examined the point prevalence of otitis media in the children from study II. Onsite otomicroscopy was completed by an otologist. Prevalence of otitis media was 24.8%, with OME the most prevalent (16.5%). Despite AOM prevalence of 1.7%, caregivers reported otalgia for 7.4% of children within two weeks of assessment. Caregivers did therefore not typically seek medical opinion for otalgia. Lack of medical opinion is problematic as the sample demonstrated high CSOM prevalence (6.6%). A telehealth facilitator with limited training was capable of acquiring good quality video-otoscopy measures in children and adults. Asynchronous video-otoscopy recordings may be used within a telehealth clinic in a primary health care clinic to reduce morbidity and mortality associated with CSOM. Speech-Language Pathology and Audiology DPhil Unrestricted 2015-01-14T06:10:25Z 2015-01-14T06:10:25Z 2015-04-22 2015 Thesis Biagio, L 2015, Telehealth for primary health care ear disorders : a study in video-otoscopy, DPhil Thesis, University of Pretoria, Pretoria, viewed yymmdd <http://hdl.handle.net/2263/43101> A2015 http://hdl.handle.net/2263/43101 en © 2015 University of Pretoria. All rights reserved. The copyright in this work vests in the University of Pretoria. No part of this work may be reproduced or transmitted in any form or by any means, without the prior written permission of the University of Pretoria. application/pdf University of Pretoria |
| spellingShingle | Audiology Telehealth Otitis Media Primary health care (PHC) UCTD Telehealth for primary health care ear disorders : a study in video-otoscopy |
| title | Telehealth for primary health care ear disorders : a study in video-otoscopy |
| title_full | Telehealth for primary health care ear disorders : a study in video-otoscopy |
| title_fullStr | Telehealth for primary health care ear disorders : a study in video-otoscopy |
| title_full_unstemmed | Telehealth for primary health care ear disorders : a study in video-otoscopy |
| title_short | Telehealth for primary health care ear disorders : a study in video-otoscopy |
| title_sort | telehealth for primary health care ear disorders a study in video otoscopy |
| topic | Audiology Telehealth Otitis Media Primary health care (PHC) UCTD |
| url | http://hdl.handle.net/2263/43101 |