视频耳镜作为一种新型教学和远程耳鼻喉科会诊工具在学术医学中心的应用。

IF 2.6 3区 医学 Q1 OTORHINOLARYNGOLOGY Otolaryngology- Head and Neck Surgery Pub Date : 2024-12-01 Epub Date: 2024-07-05 DOI:10.1002/ohn.894
Arianna Winchester, Michael Chow, William Chiang, Scott Rickert
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引用次数: 0

摘要

目的:评估视频耳镜(VO)作为急诊科住院医生教学和远程耳鼻喉科会诊工具的使用情况:评估视频耳镜(VO)作为急诊科(ED)住院医生教学和远程耳鼻喉科会诊工具的使用情况:研究设计:调查和回顾性病历审查:研究设计:调查和回顾性病历:方法:急诊科住院医师完成耳科技能自我评估和病理评估,然后进行 VO 互动培训,并在使用 9 个月后进行干预后评估。结果比较了培训前与培训后得分的变化。在此期间,对使用 VO 的急诊室会诊进行了回顾,以检测仅根据电话会诊和 VO 图像推测的诊断/治疗与耳鼻喉科会诊后最终诊断/治疗之间的差异:46名(63.1%)耳鼻喉科住院医师参与了这项研究。诊断准确率总体提高了 20.7%。诊断准确率提高最多的是正常耳道(+75%)、鼓室硬化(+58.4%)和耳道异物(+57.1%);最具挑战性的是外耳道囊肿(-13.6%)、血性鼓室(-11.3%)和耵聍(-1.9%)。胆脂瘤没有得到改善,因为所有回答都不正确;鼓膜穿孔也没有得到改善,因为所有回答都正确。对耳科检查和解剖的信心也有所提高(P使用 VO 的培训可显著提高急诊室医疗人员对许多病症的信心和诊断技能。这一应用表明了耳科电子会诊模式的有效性。
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Video Otoscopy as a Novel Teaching and Remote Otolaryngology Consultation Tool at an Academic Medical Center.

Objective: Assess the use of video otoscopy (VO) as a tool for teaching Emergency Department (ED) residents and remote Otolaryngology consultation.

Study design: Survey and retrospective chart review.

Setting: Tertiary care center.

Methods: Emergency Medicine resident physicians completed an otologic skill self-assessment and pathology followed by an interactive training on VO and postintervention assessment after 9 months of use. Outcomes compared change in pre- to posttraining scores. ED consultations using VO during this time period were reviewed to detect differences between the presumed diagnosis/treatment based only on phone consultation and VO image compared to the final diagnosis/treatment after in-person Otolaryngology consultation.

Results: Forty-six (63.1%) ED residents participated. Diagnostic accuracy improved by 20.7% overall. The most improved diagnoses were of a normal ear canal (+75%), tympanosclerosis (+58.4%), and ear canal foreign body (+57.1%); most challenging were external auditory canal cyst (-13.6%), hemotympanum (-11.3%), and cerumen (-1.9%). Cholesteatoma did not improve because all responses were incorrect; neither did tympanic membrane perforation because all were correct. Confidence in the otologic exam and anatomy also increased (P < .01). Thirteen consults used VO and 3 (23.1%) had a change in diagnosis/treatment after in-person Otolaryngology evaluation.

Conclusion: Training on the use of VO significantly improves the confidence and diagnostic skills of ED providers for many pathologies. This application suggests the efficacy of an otologic e-consultation model.

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来源期刊
Otolaryngology- Head and Neck Surgery
Otolaryngology- Head and Neck Surgery 医学-耳鼻喉科学
CiteScore
6.70
自引率
2.90%
发文量
250
审稿时长
2-4 weeks
期刊介绍: Otolaryngology–Head and Neck Surgery (OTO-HNS) is the official peer-reviewed publication of the American Academy of Otolaryngology–Head and Neck Surgery Foundation. The mission of Otolaryngology–Head and Neck Surgery is to publish contemporary, ethical, clinically relevant information in otolaryngology, head and neck surgery (ear, nose, throat, head, and neck disorders) that can be used by otolaryngologists, clinicians, scientists, and specialists to improve patient care and public health.
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