Smartphones detect ear infections

21 May 2019

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An app to detect fluid in the middle ears of babies and children, using only a smartphone and a paper cone, has been developed by researchers in the US...

Ear infection is one of the most common reasons for a visit to the doctor. Infected fluid in the middle ear, associated with fever and pain, often resolves without antibiotics, but complications can lead to meningitis and facial nerve paralysis. And even non-infected fluid, affecting up to 80% of children, can lead to an increased likelihood of later infection, as well as sleep and speech problems.

Now Justin Cha, Sharat Raju and their team from the University of Washington have found a way for parents to detect the problem early themselves, using only a smartphone and paper cone.

The smartphone speaker emits three chirps, which are funnelled onto the eardrum by the paper cone, the template for which can be printed out and assembled at home with scissors and tape.

Meanwhile, the phone's microphone records both the emitted sounds and the echoes reflected by the eardrum. The two sound waves - the chirp and the echo - interfere with one another during the journey to and from the phone. This creates a characteristic "dip" in the recording. In a healthy ear, the broad echo from the eardrum produces a wide dip.

But fluid in the canal connecting the outer to the middle ear restricts eardrum vibration, producing a narrower dip. The app uses the shape of the dip to compute the likelihood of there being fluid in the middle ear. The software uses a machine-learning algorithm, trained on data from patients from Seattle Children’s Hospital aged between 18 months and 17 years old, and has the same predictive ability in infants under 18 months old.

The power of this approach comes from its accessibility and user-familiarity. Unlike expensive equipment restricted to professional use, the app uses hardware already built into the smartphone. Furthermore, parents were able to use the apparatus with the same reliability as healthcare professionals. While other diseases which alter eardrum mobility would show up as false positives, the result would prompt follow up with a clinician who could appropriately diagnose condition.

Health care systems around the world are under great amounts of stress, both in terms of financial resources and available practitioners, whereas smartphones are becoming increasingly widespread and available, including in developing countries. Could app-based diagnostics represent the medicine of tomorrow? We’re all ears...

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