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Times Of India
21 September 2012

A new medical device that can be clipped to a cellphone could make life easier for every parent who has ever rushed to the doctor with a child screaming from an ear infection

Soon, parents may be able to skip the doctor’s visit and receive a diagnosis without leaving home by using Remotoscope, a clip–on attachment and software app that turns an iPhone into an otoscope.

Pediatricians currently diagnose ear infections using the standard otoscope to examine the eardrum. With Remotoscope, parents would be able to take a picture or video of their child’s eardrum using the iPhone and send the images digitally to a physician for diagnostic review. Wilbur Lam, assistant professor at Georgia Tech and Emory University, along with his colleagues at the University of California, Berkeley, is developing the device, with plans to commercialise it.

"Ultimately we think parents could receive a diagnosis at home and forgo the late–night trips to the emergency room, " said Lam. "It’s known that kids who get ear infections early in life are at risk for recurrent ear infections. It can beaverybigdealandreallyaffecttheirfamilies’ quality of life. "

Remotoscope's clip–on attachment uses the iPhone's camera and flash as the light source as well as a custom software app to provide magnification and record data to the phone. The iPhone’s data transmission capabilities seamlessly send images and video to a doctor's inbox or to the patient's electronic medical record.

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The device has the potential to save money for both families and healthcare systems, Lam says. Ear infections, or otitis media, affect 75 percentofchildrenbyage6,makingitthemost common diagnosis for preschoolers.

At the initial visit with a patient, physicians say it is difficult to differentiate between ear infections caused by viruses, which resolve on their own, and those caused by bacteria, which would require antibiotics.

"As pediatricians will likely only see the child once, they often err on the side of giving antibiotics for viral infections rather than risk not giving antibiotics for a bacterial infection, which can lead to complications, " Lam said. "So, we are currently over–treating ear infections with antibiotics and consequently causing antibiotic resistance. "

Lam says Remotoscope may be able to change physicians’ prescription patterns of antibiotics for ear infections. Receiving serial images of a child’s ear over several days via the Remotoscope could allow physicians to wait and see if a child’s infection improves or whether antibiotics are warranted.

A clinical trial for the Remotoscope is currently under way to see if the device can obtain images of the same diagnostic quality as what a physician sees with a traditional otoscope.

Fourth–year Emory medical student Kathryn Rappaport, who is part of the research team, is recruiting families. Once a family agrees to be in the trial and the child has seen the emergency room doctor, Rappaport takes video of the child’s ear with Remotoscope and atraditional otoscope linked to a computer.

Next, a panel of physicians will review the quality of the samples, make a diagnosis from the Remotoscope video and see if it matches the original diagnosis by the ER doctor.

Ear infections? There is an app for that too

"Alotofparentssaidtheywouldwanttouse it, which surprised me because I think it could be scary to look in someone’s ear and because I think parents would be afraid they could hurt their child, " Rappaport said.

"Parents are enthusiastic and ask me where they can get it, but we’re not there yet. "

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