Hearing an ear infection? Ear infections are typically diagnosed using specialized equipment to assess eardrum mobility: The presence of fluid in the middle ear, indicative of likely ear infection, limits eardrum mobility. Chan et al. developed a smartphone system to detect middle ear fluid that uses the microphone and speaker of a phone to emit sound and analyze its reflection (echo) from the eardrum. The smartphone system outperformed a commercial acoustic reflectometry system in detecting middle ear fluid in 98 pediatric patient ears, and the system could be easily operated by patient parents without formal medical training. This proof-of-concept screening tool could help aid in the diagnosis of ear infections. Abstract The presence of middle ear fluid is a key diagnostic marker for two of the most common pediatric ear diseases: acute otitis media and otitis media with effusion. We present an accessible solution that uses speakers and microphones within existing smartphones to detect middle ear fluid by assessing eardrum mobility. We conducted a clinical study on 98 patient ears at a pediatric surgical center. Using leave-one-out cross-validation to estimate performance on unseen data, we obtained an area under the curve (AUC) of 0.898 for the smartphone-based machine learning algorithm. In comparison, commercial acoustic reflectometry, which requires custom hardware, achieved an AUC of 0.776. Furthermore, we achieved 85% sensitivity and 82% specificity, comparable to published performance measures for tympanometry and pneumatic otoscopy. Similar results were obtained when testing across multiple smartphone platforms. Parents of pediatric patients (n = 25 ears) demonstrated similar performance to trained clinicians when using the smartphone-based system. These results demonstrate the potential for a smartphone to be a low-barrier and effective screening tool for detecting the presence of middle ear fluid. Source
