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Artificial intelligence model outperforms clinicians in diagnosing pediatric ear infections

An artificial-intelligence (AI) model built at Mass Eye and Ear was shown to be significantly more accurate than doctors at diagnosing pediatric ear infections in the first head-to-head evaluation of its kind, a research team working to develop the model for clinical use reported.

According to a new study published August 16 in Otolaryngology-Head and Neck Surgery, the model, called OtoDX, was more than 95 percent accurate in diagnosing an ear infection in a set of 22 test images compared to 65 percent accuracy among a group of clinicians consisting of ENTs, pediatricians and primary care doctors, who reviewed the same images.

When tested in a dataset of more than 600 inner ear images, the AI model had a diagnostic accuracy of more than 80 percent, representing a significant leap over the average accuracy of clinicians reported in medical literature.

The model utilizes a type of AI called deep learning and was built from hundreds of photographs collected from children prior to undergoing surgery at Mass Eye and Ear for recurrent ear infections or fluid in the ears. The results signify a major step towards the development of a diagnostic tool that can one day be deployed to clinics to assist doctors during patient evaluations, according to the authors. An AI-based diagnostic tool can give providers, like pediatricians and urgent care clinics, an additional test to better inform their clinical decision-making.

“Ear infections are incredibly common in children yet frequently misdiagnosed, leading to delays in care or unnecessary antibiotic prescriptions,” said lead study author Matthew Crowson, MD, an otolaryngologist and artificial intelligence researcher at Mass Eye and Ear, and assistant professor of Otolaryngology-Head and Neck Surgery at Harvard Medical School. “This model won’t replace the judgment of clinicians but can serve to supplement their expertise and help them be more confident in their treatment decisions.”

Difficult to diagnose common condition

Ear infections occur from a buildup of bacteria inside the middle ear. According to the National Institute on Deafness and Other Communication Disorders, at least five out of six children in the United States have had at least one ear infection before the age of three. When left untreated, ear infections can lead to hearing loss, developmental delays, complications like meningitis, and, in some developing nations, death. Conversely, overtreating children when they don’t have an ear infection can lead to antibiotic resistance and render the medications ineffective against future infections. This latter problem is of significant public health importance.

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