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Parent-led Assessment and Recognition of AOM Using Digital Ear Imaging (PARENT-EAR)

4. September 2026 aktualisiert von: Paula Tähtinen, Turku University Hospital

Acute otitis media (AOM) is the most common bacterial infection in young children and a major contributor to healthcare utilization and costs. Diagnosis relies on otoscopy and identification of tympanic membrane (TM) bulging, yet physician-performed otoscopy has variable diagnostic accuracy and depends heavily on clinical expertise.

Digital otoscopy combined with artificial intelligence (AI)-based image analysis has demonstrated high diagnostic accuracy in previous studies. In a recent study by our group, digital otoscopy with an automated neural network classifier reliably ruled out otitis media in children.

The PARENT-EAR randomized controlled pilot trial aims to evaluate whether parent-performed digital otoscopy at home, combined with retrospective AI analysis of captured TM images, can reduce physician visits due to suspicion of AOM. The study also assesses feasibility, diagnostic accuracy of parents after training, and potential effects on antibiotic use and healthcare utilization.

Methods and outcomes The PARENT-EAR trial is a randomized controlled pilot trial conducted at Vaasa Central Hospital and Turku University Hospital. Recruitment will occur between September and December 2026 (extended if necessary), with follow-up ending May 31, 2027 (5-9 months per participant).

Children aged 12 to 47 months with at least one AOM episode in the past 12 months will be randomized 1:1 using permuted block randomization. Exclusion criteria include tympanostomy tubes, tympanic membrane perforation, middle ear effusion at recruitment, immunosuppression, previously diagnosed hearing loss or anatomical abnormalities predisposing to AOM, and otoscopy experience of the parent.

Intervention group:

Parents receive a digital otoscope (The Ear Puffin by Sibbo Medical Devices, MDR EU Class I device) and training on TM image interpretation. They complete a TM image classification quiz before and after the training. During follow-up, parents perform home otoscopy when suspecting AOM, capture TM images/videos, interpret findings, and record symptoms in a diary. If AOM is suspected or the child appears ill, medical evaluation is instructed.

Control group:

Standard care without home otoscopy. Parents complete the same symptom diary and seek care according to usual practice.

Statistical analyses will compare outcomes between groups. AI-based TM classification will be compared against expert panel evaluation.

This is a pilot study with a target sample size of 20 children per arm, limited by device availability.

Ethical aspects, data collection and handling The study will be conducted in accordance with the Declaration of Helsinki. Written informed consent will be obtained from all parents after provision of oral and written information. Participation is voluntary, and families may withdraw at any time. Investigators may discontinue participation if deemed in the child's best interest.

The digital otoscope is a CE-marked Class I medical device used solely for visual inspection of the tympanic membrane. Pneumatic pumps are not provided. Potential risks include minor ear canal abrasions or discomfort; serious adverse events are considered rare. Any adverse events will be managed according to standard clinical practice and reported to relevant authorities when required. The study is investigator-initiated. The device manufacturer provides the otoscopes but has no role in study design, data access, or analysis.

Data will be collected via paper symptom diaries, monthly REDCap questionnaires (University of Turku), and national electronic health records (Kanta). TM images and videos will be securely stored and imported into a research database with relevant metadata.

All data will be handled in accordance with the EU General Data Protection Regulation (GDPR 2016/679). Study data will be pseudonymized and identified only by study ID numbers. The key linking personal identifiers to study IDs will be stored separately and securely. Paper diaries will be destroyed after digitalization. Consent includes permission to access health records and to use collected images and data for scientific purposes. Results will be published in peer-reviewed journals and as part of a doctoral thesis.

Studienübersicht

Status

Rekrutierung

Bedingungen

Intervention / Behandlung

Studientyp

Interventionell

Einschreibung (Geschätzt)

40

Phase

  • Unzutreffend

Kontakte und Standorte

Dieser Abschnitt enthält die Kontaktdaten derjenigen, die die Studie durchführen, und Informationen darüber, wo diese Studie durchgeführt wird.

Studienkontakt

Studieren Sie die Kontaktsicherung

Studienorte

    • Pohjanmaa
      • Vaasa, Pohjanmaa, Finnland, 65130
        • Rekrutierung
        • Vaasa Central Hospital
        • Kontakt:
        • Kontakt:
    • Southwest Finland
      • Turku, Southwest Finland, Finnland, 20521
        • Noch keine Rekrutierung
        • Turku University Hospital
        • Kontakt:
        • Kontakt:
          • Lotta E Ivaska, MD, PhD
          • Telefonnummer: +35823130000
          • E-Mail: lesaar@utu.fi

Teilnahmekriterien

Forscher suchen nach Personen, die einer bestimmten Beschreibung entsprechen, die als Auswahlkriterien bezeichnet werden. Einige Beispiele für diese Kriterien sind der allgemeine Gesundheitszustand einer Person oder frühere Behandlungen.

Zulassungskriterien

Studienberechtigtes Alter

  • Kind

Akzeptiert gesunde Freiwillige

Ja

Beschreibung

Inclusion Criteria:

  • At least one episode of AOM within the last 12 months
  • Family speaks fluent Finnish

Exclusion Criteria:

  • Tympanostomy tubes or perforation of the TM, or scheduled for upcoming tympanostomy
  • Middle ear fluid at the time of recruitment
  • Previously diagnosed hearing loss
  • Immunosuppressive disorder or medication, excluding inhaled corticosteroids
  • Anatomic defect or anomaly affecting the susceptibility to AOM
  • Previous otoscopy experience of the participating parent

Studienplan

Dieser Abschnitt enthält Einzelheiten zum Studienplan, einschließlich des Studiendesigns und der Messung der Studieninhalte.

Wie ist die Studie aufgebaut?

Designdetails

  • Hauptzweck: Diagnose
  • Zuteilung: Zufällig
  • Interventionsmodell: Parallele Zuordnung
  • Maskierung: Keine (Offenes Etikett)

Waffen und Interventionen

Teilnehmergruppe / Arm
Intervention / Behandlung
Experimental: Intervention group
Intervention group to receive the digital otoscope
Parents receive a digital otoscope (The Ear Puffin by Sibbo Medical Devices, MDR EU Class I device) and training on TM image interpretation. They complete a TM image classification quiz before and after the training. During follow-up, parents perform home otoscopy when suspecting AOM, capture TM images/videos, interpret findings, and record symptoms in a diary. If AOM is suspected or the child appears ill, medical evaluation is instructed.
Kein Eingriff: Control group
Control group with no intervention

Was misst die Studie?

Primäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Number of physician visits due to suspected AOM
Zeitfenster: 5 to 9 months, depending on date of recruitment
Number of physician visits due to suspected AOM
5 to 9 months, depending on date of recruitment

Sekundäre Ergebnismessungen

Ergebnis Maßnahme
Maßnahmenbeschreibung
Zeitfenster
Agreement between parent interpretation, AI classifier, and expert gold standard
Zeitfenster: 5 to 9 months, depending on date of recruitment
Parent's interpretation of the tympanic membrane image is retrospectively compared to the expert's gold standard and classification by an artificial intelligence classifier
5 to 9 months, depending on date of recruitment
Antibiotic prescription rates
Zeitfenster: 5 to 9 months, depending on date of recruitment
Antibiotic prescription rates for AOM in both arms
5 to 9 months, depending on date of recruitment
Adverse events related to otoscopy
Zeitfenster: 5 to 9 months, depending on date of recruitment
Adverse events, such as abrasion, related to otoscopy in the experimental group
5 to 9 months, depending on date of recruitment
AOM-related complications
Zeitfenster: 5 to 9 months, depending on date of recruitment
AOM-related complications, such as mastoiditis, in both arms
5 to 9 months, depending on date of recruitment
Daycare absence
Zeitfenster: 5 to 9 months, depending on date of recruitment
Child's absence from daycare due to suspected AOM
5 to 9 months, depending on date of recruitment
Parental work absenteeism
Zeitfenster: 5 to 9 months, depending on date of recruitment
Parental work absenteeism due to suspected AOM
5 to 9 months, depending on date of recruitment
Parental satisfaction on a visual analog scale (VAS)
Zeitfenster: 5 to 9 months, depending on date of recruitment
Parental satisfaction in the experimental group of AOM management with parent-led digital otoscopy
5 to 9 months, depending on date of recruitment

Mitarbeiter und Ermittler

Hier finden Sie Personen und Organisationen, die an dieser Studie beteiligt sind.

Sponsor

Mitarbeiter

Ermittler

  • Hauptermittler: Paula A Tähtinen, MD, PhD, Department of Paediatiatrics and Adolescent Medicine, Turku University Hospital and University of Turku, Finland

Publikationen und hilfreiche Links

Die Bereitstellung dieser Publikationen erfolgt freiwillig durch die für die Eingabe von Informationen über die Studie verantwortliche Person. Diese können sich auf alles beziehen, was mit dem Studium zu tun hat.

Studienaufzeichnungsdaten

Diese Daten verfolgen den Fortschritt der Übermittlung von Studienaufzeichnungen und zusammenfassenden Ergebnissen an ClinicalTrials.gov. Studienaufzeichnungen und gemeldete Ergebnisse werden von der National Library of Medicine (NLM) überprüft, um sicherzustellen, dass sie bestimmten Qualitätskontrollstandards entsprechen, bevor sie auf der öffentlichen Website veröffentlicht werden.

Haupttermine studieren

Studienbeginn (Tatsächlich)

1. September 2026

Primärer Abschluss (Geschätzt)

31. Mai 2027

Studienabschluss (Geschätzt)

31. August 2027

Studienanmeldedaten

Zuerst eingereicht

27. Mai 2026

Zuerst eingereicht, das die QC-Kriterien erfüllt hat

6. Juni 2026

Zuerst gepostet (Tatsächlich)

10. Juni 2026

Studienaufzeichnungsaktualisierungen

Letztes Update gepostet (Tatsächlich)

8. September 2026

Letztes eingereichtes Update, das die QC-Kriterien erfüllt

4. September 2026

Zuletzt verifiziert

1. September 2026

Mehr Informationen

Begriffe im Zusammenhang mit dieser Studie

Andere Studien-ID-Nummern

  • VARHA/4418/13.02.01/2026

Plan für individuelle Teilnehmerdaten (IPD)

Planen Sie, individuelle Teilnehmerdaten (IPD) zu teilen?

JA

Beschreibung des IPD-Plans

Deidentified participant data will be made available upon reasonable request from the corresponding author.

IPD-Sharing-Zeitrahmen

Study protocol will be published as supplementary material alongside the study manuscript alongside publication.

IPD-Sharing-Zugriffskriterien

Deidentified participant data will be made available to fellow researchers upon reasonable request from the corresponding author.

Art der unterstützenden IPD-Freigabeinformationen

  • STUDIENPROTOKOLL

Arzneimittel- und Geräteinformationen, Studienunterlagen

Studiert ein von der US-amerikanischen FDA reguliertes Arzneimittelprodukt

Nein

Studiert ein von der US-amerikanischen FDA reguliertes Geräteprodukt

Nein

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