Otoscopy in the diagnosis of otitis media with effusion: A study of observer agreement amoung otorhinolaryngologists

• Autor(a) principal: Azevedo, Cátia
• Data de Publicação: 2020
• Outros Autores: Machado, João Firmino, Sousa Menezes, Ana, Costa, Ana Isabel, Fontes Lima, Antonio, Vilarinho, Sérgio, Dias, Luís
• Tipo de documento: Artigo
• Idioma: por
• Título da fonte: Repositório Científico de Acesso Aberto de Portugal (Repositórios Cientìficos)
• Texto Completo: https://doi.org/10.34631/sporl.842
• topic: Otitis Media with Effusion; Otoscopy; Otorhinolaryngologists; Interobserver agreement; Intraobserver agreement; Sensitivity; Otite Média com Efusão; Otoscopia; Otorrinolaringologistas; Concordância inter-observador; Concordância intra-observador; Sensibilidade

Aim: To study otoscopy in terms of interobserver and intraobserver agreement, accuracy, sensitivity, specificity, positive and negative predictive value for the diagnosis of otitis media with effusion (OME) in children.  Study Design: Cross-sectional study and agreement analysis.  Methods: We presented otoscopy images to Otorhinolaryngology specialists and residents and they were instructed to identify the images that corresponded to cases of OME. The same test was repeated 1 month later, with the same images in a different order. We considered that the images were positive for OME whenever the respective tympanogram was type B.  Results: Thirty-one otoscopy images and 1240 responses provided by 10 specialist doctors and 10 residents of Otorhinolaryngology were analyzed. Overall mean accuracy was 74.8%. Sensitivity of otoscopy in the diagnose of OME was 81.5% when performed by specialists doctors and 70.0% when performed by residents (p <0.05). Specificity was 69.4% and 76.1% in the group of specialists and residents physicians, respectively. Intraobserver agreement was moderate for both groups (κ = 0.41-0.6). The interobserver agreement was, in general, weak (κ <0.4).  Conclusion: When performed by Otorhinolaryngology specialists, otoscopy can be a good screening test. However, given the overall low specificity and interobserver agreement, additional evaluation with other tests is necessary.