Direct to Consumer

Oral Presentation

(DTC3-02) Digital Telehealth Examination Tools Show Parity to Conventional Physical Examination Tools

Sunday, April 23
2:15 PM - 2:45 PM
Location: W224 CD

Objectives
TytoCare is a suite of handheld digital examination tools with integrated software for recording and wirelessly transmitting physical examination data of the ears, throat, heart and lungs to inform a remote telehealth diagnosis.

The aim of our study was to evaluate how physical examination findings reached by a physician using a TytoCare device compared to those reached by a physician using conventional examination tools.

Methods
Department of Emergency Medicine. Schneider Children’s Medical Center of Israel, Petach Tikvah, and the Sackler School of Medicine, Tel Aviv University, Ramat Aviv, Israel.

Prospective study. One hundred thirty-eight children ages 2-18 years presenting to an emergency dept. (ED) of a tertiary care facility met eligibility criteria and were enrolled. Participants were first examined (right ear, left ear, heart, right lung, left lung and throat) by a physician using the TytoCare device and later by an ED senior physician using conventional examination tools (Conventional Examinations). The TytoCare Assisted and Conventional Examinations were compared and analyzed using the Chi-square and Kappa tests for agreement. Examinations were given one of three assessments: normal, not normal, or not possible to tell. The quality of the data retrieved and user experience for the TytoCare device were evaluated using a scale of 1-5, where 1 is poor and 5 is excellent, adverse events were recorded.


Results
Of the 138 children studied, 59% were boys. The average age was 8.1 years ± 4 (S.D.).
The agreement (kappa) for right ear, left ear, heart, right lung, left lung and throat examinations resulted in 0.467, 0.781, 0.674(1), 0.905, 1, 0.796, respectively, where 1 is perfect agreement, >.75 is excellent agreement, .40 to .75 is average to good agreement, < .4 is weak agreement, 0 is agreement by chance and < 0 is no chance agreement. The average quality measured for the Tyto device was 3.93, 4, 4.94, 4.35, 4.31, 4.9, and the average user experience was 4.64, 4.76, 4.95, 3.92, 4.1, 4.76, respectively. No adverse events were recorded.


Conclusion
Diagnoses achieved with TytoCare corresponded closely with those reached by Conventional Examination. In addition, the quality of the readings and user experience received positive ratings from physicians and no adverse effects were recorded. As such, the TytoCare device shows promise as a tool to assist in the accurate diagnosis of patients as part of a telehealth visit.

Yehezkel (hezi) Waisman

Director of the Pediatric Emergency Department, Schneider Children’s Medical Center of Israel, Israel
Schneider Children’s Medical Center of Israel, Israel

Specialist in pediatrics and pediatric emergency medicine. Chairman of Emergency Medicine at Schneider Children's Medical Center of Israel (1992-present). Appointments: Associate Professor, Tel-Aviv University, Sackler School of Medicine. Founder and Medical Director of the Pediatricians On-Line Service at the Clalit HMO in Israel (2009-present). Past Chairman of the Israeli Association for Emergency Medicine (IAEM, 1995-2000) and Immediate Past Chairman of the Pediatric Emergency Medicine Section at IAEM (2006-2014). Past Chairman of the Pediatric Section at the European Society for Emergency Medicine (EuSEM), and the European Research in Pediatric Emergency Medicine (REPEM) Committee (2006-2012).

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Assaf Sharabi

Board certified in Pediatrics at the Schneider Children’s Medical Center of Israel, Israel
Schneider Children’s Medical Center of Israel, Israel

Graduate of the School of Medicine, Ben-Gurion University of the Negev, Israel. Completed his residency in Pediatrics at the Schneider Children’s Medical Center of Israel, Israel. Carried out six months of research on telemedicine as part of his residency requirements.

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(DTC3-02) Digital Telehealth Examination Tools Show Parity to Conventional Physical Examination Tools



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