General practitioners (GPs) play an essential role in the management of ear disease, but their diagnosis of pathologic eardrums is inadequate. The aim of this study was to compare the quality of otoscopic diagnosis by GPs using a conventional otoscope versus a video-otoscope.

Subjects and method Eleven GPs included 124 patients with ear complaints (193 otoscopies). Examination successively used conventional otoscopy and video-otoscopy. After each type of examination, a 10-criterion assessment questionnaire was filled out and a diagnosis was proposed. Two blinded ENT specialists reviewed the video-otoscopy images and filled out the same grid questionnaire to make their diagnosis. GPs also completed a Likert-scale satisfaction questionnaire on video-otoscopy.

There were no significant differences in overall examination results between the three groups (GP conventional otoscopy, GP video-otoscopy and ENT specialist). However, focusing exclusively on pathologic eardrums, there was a significant difference in results between ENT specialists and GPs using a conventional otoscope (P=0.0032); this was not the case when GPs used video-otoscopy (P=0.0754). All GPs expressed enthusiastic interest in video-otoscopy, even when not convinced to make the purchase.

Video-otoscopy showed superiority over conventional otoscopy in assessing pathological eardrums.