Symptoms of an ear infection are hard to catch and sometimes even harder for kids to communicate — the most warning parents tend to get is a fussy kid acting out or not being able to sleep.
But that could change after research findings announced last week by a team of scientists from the University of Washington. Justin Chan, PhD student, and Shyam Gollakota, associate professor at the Paul G. Allen School of Computer Science and Engineering, have developed a smartphone application that uses the device’s speakers and microphones to detect fluid found in the middle ear, a common precursor to an ear infection.
To use Chan and Gollakota’s new application, all you need is a phone and a piece of paper rolled up into a funnel. After a parent places the paper funnel into the ear of the grumpy subject, the phone emits an audible chirp from its speakers in the direction of the eardrum. The reflection of the acoustic waves are picked up by the microphones on the device. Using an algorithm, the software can determine whether there is fluid in the middle ear or if it’s clear.
“At a high level, it is like tapping a wine glass. Depending on how much liquid is in it, you get different sounds. In our case, we are not tapping but sending sounds, and using machine learning on these sounds to detect the presence of liquid,” says Chan.
The team trained the machine learning software to determine if the ear has fluid in it with data from 53 kids between the ages of 18 months and 17 years at Seattle’s Children Hospital. The algorithm correctly identified fluid 85% of the time when tested on a range of children who were slated to have surgery meant to resolve the issue. It worked even better on younger children, with an accuracy rate of 95%, according to a press release about the research.
Ear infections are challenging to diagnose in ordinary circumstances. Currently, clinicians use equipment only found at hospitals and doctors’ offices, meaning parents need to seek potentially expensive medical attention whenever their kids exhibit symptoms. The researchers hope to reduce time and cost associated with these and other kinds of health visits through using the technologies found in smart devices at home.
The app is part of a larger trend, where the device everyone has in their pocket plays an ever increasing role in day-to-day health. Mobile apps are identified as part of the push for digital health adoption by the U.S Food and Drug Administration (FDA). This is occurring at the same time as more people turn to potentially dubious at-home medical tests to save money on medical bills.
The variety of sensors on a phone means it could eventually approximate Star Trek’s Tricorder, a handheld device the characters on the show used to detect all sorts of ailments. The goal of creating an all-in-one health diagnostic device has also been the subject of a $10 million XPRIZE award.
Medical experts say many barriers remain before smartphone-collected data can factor into doctors’ diagnostic routines. But that hasn’t slowed down the growth of the industry: The mobile health market had revenues pegged at $2.3 billion in 2018 and they could explode to $289.4 billion by 2025.
“Our lab has done a large number of projects where we can detect various medical conditions including sleep apnea, opioid overdoses, and now ear infections, all with smartphones,” says Gollakota. “So what we are showing is that we don’t really need to design a new piece of hardware for trying to imitate the Star Trek Tricorder.”
The sensors found in smart devices are enabling a number of other health applications, like Aterica Digital Health’s Veta smart case for epinephrine auto-injectors like EpiPens. It can detect the location of the EpiPen, when the case is opened for the injector to be used, and what the temperature the epinephrine is kept at to maintain its potency.
Useful for parents with forgetful children, the case is made possible by the Bluetooth connection of the phone — as well as the ubiquity of the devices. “Young people’s smartphones have become attached to their hip — you’re more likely to lose your keys than your cell phone,” says Mike Fisher, vice-president of marketing and business development at Aterica. Eventually, Fisher sees the protected data the app collects, like the time the EpiPen is used, as useful during any future medical attention.
But exactly how will that data be applied in a traditional medical setting?
“The value proposition of having this additional information is not immediately obvious in terms of what we currently consider the clinical standard of care,” says Dr. Juan Espinoza, medical director of the Children’s Hospital Los Angeles Innovation Studio. In other words, while these applications and accessories do have the ability to collect a ton of data, doctors are still unlikely to change treatment plans based on them.
Nevertheless, Espinoza believes that more trials, like the one by Chan and Gollakota, will help determine appropriate use cases for mobile devices in health care. As well, the growing role telehealth plays in treatment will necessitate the adoption of remote data collection — provided it’s communicated over privacy-protected channels.
Accessibility of digital health services is also something which requires close attention, according to Espinoza. Even though the emerging industry could offer cost savings for some groups, a large percentage of children requiring medical treatment use programs like Medicaid which might not include support for mobile health apps. “Somebody has to physically buy it, right?” says Espinoza. “And if you depend on the patient buying it, then you are almost, by design, leaving out patients who are from lower socioeconomic backgrounds.”
The University of Washington team hopes to bring the technology to market after getting approval from the FDA by the end of the year. For now, and the foreseeable future, cranky kids will still have to pile into their parents’ back seats for a trip to the doctor’s office and a probe in the ear.