An artificial intelligence computer-vision algorithm to triage otoscopic images from Australian Aboriginal and Torres Strait Islander children

Al Rahim Habib*, Graeme Crossland, Hemi Patel, Eugene Wong, Kelvin Kong, Hasantha Gunasekera, Brent Richards, Liam Caffery, Chris Perry, Raymond Sacks, Ashnil Kumar, Narinder Singh

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

17 Citations (Scopus)

Abstract

Objective: To develop an artificial intelligence image classification algorithm to triage otoscopic images from rural and remote Australian Aboriginal and Torres Strait Islander children. Study Design: Retrospective observational study. Setting: Tertiary referral center. Patients: Rural and remote Aboriginal and Torres Strait Islander children who underwent tele-otology ear health screening in the Northern Territory, Australia between 2010 and 2018.Intervention(s): Otoscopic images were labeled by otolaryngologists to classify the ground truth. Deep and transfer learning methods were used to develop an image classification algorithm. Main Outcome Measures: Accuracy, sensitivity, specificity, positive predictive value, negative predictive value, area under the curve (AUC) of the resultant algorithm compared with the ground truth. Results: Six thousand five hundred twenty seven images were used (5927 images for training and 600 for testing). The algorithm achieved an accuracy of 99.3% for acute otitis media, 96.3% for chronic otitis media, 77.8% for otitis media with effusion (OME), and 98.2% to classify wax/obstructed canal. To differentiate between multiple diagnoses, the algorithm achieved 74.4 to 92.8% accuracy and an AUC of 0.963 to 0.997. The most common incorrect classification pattern was OME misclassified as normal tympanic membranes. Conclusions: The paucity of access to tertiary otolaryngology care for rural and remote Aboriginal and Torres Strait Islander communities may contribute to an under-identification of ear disease. Computer vision image classification algorithms can accurately classify ear disease from otoscopic images of Indigenous Australian children. In the future, a validated algorithm may integrate with existing telemedicine initiatives to support effective triage and facilitate early treatment and referral.

Original languageEnglish
Pages (from-to)481-488
Number of pages8
JournalOtology and Neurotology
Volume43
Issue number4
DOIs
Publication statusPublished - 1 Apr 2022

Keywords

  • Artificial intelligence
  • Computer-vision
  • Deep learning
  • Image classification
  • Machine learning
  • Otitis media
  • Otoscopy
  • Triage

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