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A smartphone app that can hear ear infections in children (washington.edu)
63 points by curtis on June 1, 2019 | hide | past | favorite | 33 comments



Reporting an accuracy of 85% doesn't mean much in a medical context. Reporting the Sensitivity/Specificity should be the norm.


You're correct. They included a link to the actual paper: https://stm.sciencemag.org/content/11/492/eaav1102

According to the paper, they achieved 85% sensitivity and 82% specificity (N=98)


Also sort of pointless since most ear infections don’t need treatment.


Not pointless at all. If you can track it easily at home and only visit the doctor when it becomes an issue that's a win for everyone.


Most people who find out their kid has an ear infection will take them to the doctor and demand antibiotics. Even if it’s viral.


Tell me more about this viral ear infection.


Also, the app could support an educational component: "You should see your doctor because diagnosis and testing may be more involved based on the evaluation of a trained professional. Some ear infections may surgery, while others may not even require antibiotics. See your doctor."


Absolutely not. Kids age < 4 get these all the time. When they cry or feel bad, you don't know if you want to go to doctor all the time. For poor people this is even more difficult decision. Ear infections when treated early can be much less painful or even dangerous. This kind of apps is definitely useful.


> For poor people this is even more difficult decision.

Depends where you live. In The Netherlands I get the doctor visits for my toddler reimbursed by (mandatory) insurance. My problem is rather that I need to make (precious) time for a doctor visit. Time is money.


[flagged]


Please don't post personally abrasive comments to HN.

Also, could you please stop posting unsubstantive comments generally? We're trying for higher signal/noise ratio here, which those lower quite a bit.

https://news.ycombinator.com/newsguidelines.html


Eh, thanks for that (offensive) question, you're the first in my life who ever asked me that question. It is a good question though, so I'll address it (from my PoV, n=1).

First of all, every parent in the world has this problem because as parent your time is limited. More so than non parents. There are some parents who outsource their children to (day)care. We don't have the financial means for that, but we'd also limit it regardless because contact with our child is important.

Second, yes I've been wondering about that various times in the recent past, but for very different reasons (I have autism and get over-sensitized from children because of the unpredictability and the noise).

Third, you don't know beforehand the exact problems you're going to face with your child. Not from your part, but even less from your child's PoV because you don't know how their personality is and how it is going to develop. Furthermore, you don't know for sure how your situation and the world is going to develop.

Money and time are both limiting factors. While in The Netherlands the doctor visits are reimbursed via insurance, the limiting time factor remains.

I would make time for my kid when required. The problem is that you never know for sure when it is required. Because you don't know for sure when your kid is really ill. Its a risk assessment, in the end. Right now, she has the sixth disease (Roseola) which is the first time she got really ill, and it seems like a harmless virus.


I am not a medical professional, so I may be getting some details wrong, but my understanding is that many pediatricians over-prescribe antibiotics for ear-infections (sometimes due to demands of the parents), and having additional information may help in this regard.

Over-prescribing antibiotics is bad because (1) some children have serious allergic reactions to them (and sometimes these develop over time), (2) they contribute to the evolution of antibiotic resistance.


I am nearly deaf thanks to unattended childhood ear infections. You could not be more wrong.


It would have had to have been unattended for a very long time.

Current guidance is to wait a couple days to see if it clears up, and only if it doesn't after several days then see a doctor.

You would not have hearing damage after just several days.


The context is that someone claimed it's pointless to even diagnose them. An undiagnosed problem isn't going to be following that guidance.


It's not necessary to diagnose it until several days have passed.

That's not to say just ignore the earache, but you don't have to go to the doctor to get a diagnosed for couple days. Only if it's still there after a couple days then go.


Here (Slovenia) you get told off severely if you don't come immediately when the pain starts. And if there's no pain but you feel a fluid buildup, you're supposed to get checked regularly until it subsides (am currently in that state, non-infected fluid buildup in my ear after a viral infection).


Does your doctors have incentives for regular checkups?


Even if they don't need treatment, it's useful to know why your child is screaming/complaining.


Making the diagnosis of any medical condition easier necessarily can't be pointless


[flagged]


Please don't make personal attacks in HN comments, regardless of how wrong some other commenter is. They break the site guidelines and ruin the informational value of what you're saying. Your comment would have been just fine without the first and fourth paragraphs.

https://news.ycombinator.com/newsguidelines.html


You are right, but can we please start flagging bad medical advice on this site. Otherwise we might as well allow anti-vax posts.


In general we can't, because neither users nor moderators are in a position to judge bad medical advice. There are genuine medical experts on HN, but they only pop up occasionally.


Looks cool. If the app was on the play store I'd test it out, but looks like its not released. Below is the relevant quote from the story which links to their website which has no info.

"The researchers plan on commercializing this technology through a spinout company, Edus Health [1], and then making the app available to the public."

[1] http://edushealth.com/


"Our mission is to make pediatric healthcare more accessible."

Well, they could just release the algorithm / paper / java / app if they really wanted to make it more accessible.

I agree they should be rewarded for their findings, but these kinds of healthcare apps should be free and open source


How exactly would that work? Should the government offer to buy it for the asking price and then release it for free? What if the asking price is overly inflated because the government with it's endless budget is buying it? What if the government prefers to buy products that were developed in a variety of states and by a variety of people with different skin colors and chromosomes?

Or should it be illegal for researchers to sell these type of product? That will cause all of the brilliant talented people who need money to look elsewhere for work. I wonder if they will be able to get a competent team.


If we restrict the debate to children healthcare, I believe it is unethical to sell an app that could do great goods to many of them, at no additional cost to maintain or operate. The children are considered a vulnerable population, they will never buy themselves healthcare or even be able to.

However, this is a smart finding so the researchers definitely deserve some sort of reward, either in fame or funding.


Even if we restrict it to children, it doesn't change the basic idea. We can advertise food, education, housing and toys that are meant for children, why is a health app different? I doubt they the company actually wants children to buy their app, rather that parents will buy it for their children.


My son was in the data set for this! I'm delighted to finally see the paper!


This could be very useful for adults as well. I work in scuba diving and am definitely in interested in this app.


Are ear infections common for divers? Is protective ear gear not common/not effective?


Very common.

I spend on average 4 hours a day underwater in tropical seas loaded with bacteria.

Protective ear gear is available, however it impedes the ears natural ability to equalize pressure under water and can easily lead to permanent barotrauma (pressure injuries). I have been diving recreationally for 20 years and professionally for 4 and have never met a diver who uses them.

Typically they take the form of a mask with "ear muffs" that are connected to the the front of the mask by hollow tubes that allow you to equalize pressure. I tried them once and found them ineffective and borderline dangerous.

The most effective way that I have found to prevent ear infections while diving is to use "ear beer" drops that are equal parts alcohol and white vinegar. Some divers add oil to make a nice vinaigrette. I am being totally serious.

I use the drops for 5 minutes in each ear after I shower before bed, and after every single dive I clean my ears with fresh water.





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