Innovations for pediatric otitis media screening for community pharmacy practice in Thailand: A scoping review and conceptual research and development with preliminary testing

ABSTRACT

Background: Accurate differentiation of acute otitis media (AOM) and otitis media with effusion (OME) requires direct visualization of the tympanic membrane (TM), yet front-line assessment remains challenging in community settings, contributing to unnecessary antibiotic prescribing. This review synthesized contemporary evidence on patient-operable otoscopic technologies to inform diagnosis-first pediatric ear care and evidence-based device development. Methods: A PRISMA-ScR–compliant scoping review following the Arksey and O’Malley framework was conducted. MEDLINE, Embase, Web of Science, Scopus, Cochrane CENTRAL, IEEE Xplore, trial registries, Thai databases, and grey literature were searched (2000–present). Eligible studies evaluated patient-operated or patient-operable technologies for pediatric otitis media, including smartphone video otoscopy, artificial intelligence (AI), short-wave infrared (SWIR) otoscopy, optical coherence tomography (OCT), and adjunctive tympanometry. Evidence was narratively synthesized, and methodological limitations were mapped. Results: Contemporary evidence consistently supports a diagnosis-first strategy requiring confirmation of middle-ear effusion and TM inflammatory signs before antibiotic treatment. Smartphone-based video otoscopy combined with AI represents the most mature front-line technology, demonstrating reported diagnostic accuracy ranging from approximately 85% to 95%, feasibility for tele-otology, and potential to reduce unnecessary antibiotic use. SWIR and OCT provide higher-confidence confirmatory assessment of middle-ear effusion (reported sensitivity/specificity 80–91%) but remain constrained by cost and operational complexity. Evidence synthesis further informed the conceptual design of a child-friendly video otoscopy platform integrating an adjustable-focus micro-camera, standardized image-quality assurance, and tele-otology compatibility. Conclusions: Smartphone-assisted video otoscopy, supported by AI and standardized imaging protocols, is currently the most practical technology for diagnosis-first pediatric otitis media screening. Evidence-informed device development and integration into community pharmacy and primary care may strengthen antimicrobial stewardship, although prospective multicentre clinical validation remains essential before routine implementation.

KEYWORDS

• acute otitis media screening
• video otoscopy
• tele-otology
• antimicrobial stewardship
• pediatric diagnostics

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• DOI10.18549/PharmPract.2026.3.3568Copy

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