Development and validation of a new grading scale for otitis media

Area of Science:

• Otolaryngology
• Medical Imaging
• Clinical Diagnostics

Background:

• Accurate grading of acute otitis media (AOM) is crucial for clinical practice and research.
• Existing AOM grading scales rely on tympanic membrane (TM) redness and bulging, using 6-9 point systems.
• There is a need for a validated, reliable AOM grading scale.

Purpose of the Study:

• To develop and validate a novel, image-based grading scale for acute otitis media (AOM).
• To assess the reliability of the new AOM grading scale.

Main Methods:

• A 3-stage development process involving expert committees and content validity.
• Utilized TM images from 32 patients with otalgia and during follow-up.
• Tested reliability using a separate expert panel, calculating inter-rater and intra-rater agreements (test-retest).

Main Results:

• The scale was refined through expert consensus, deeming vascularization less critical.
• The final scale achieved moderate inter-rater agreement (κ = 0.52).
• Good intra-rater agreement was observed (κ = 0.66–0.89) during test-retest reliability assessments.

Conclusions:

• The developed image-based AOM grading scale exhibits significant inter- and intra-rater reliability.
• This scale holds potential for application in clinical research and telemedicine.
• The parameter of TM redness was found to be of lesser importance in this scale compared to others.