ENT Question Bank iPhone App for Physicians and Residents

The AAO-HNS has released a nifty iPhone app that contains 400+ Q&A to test one's knowledge in the field of otolaryngology. Called AcademyQ, it is free for 10 sample questions, but $49.99 to access the entire question bank.

Although anybody can download the app (link to app store), it's really meant for busy ENT surgeons. This app may be worthwhile to quiz oneself on esoteric ENT trivia in between surgical cases and patient office visits where one might have a minute or two to go through a few questions.

The questions are similar to the ones one may encounter in the Home Study Course.

More debatable is whether such a question bank is helpful in preparing for Board-Certification or Recertification.

In any case, for example, one of the sample questions is:

Whether you get the question right or wrong, an extensive answer is provided to explain further:

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Bracelet that Measures Your Sun Exposure

June is being worn on this model's wrist.

At the CES 2014, an interesting bracelet made an appearance that purportedly is able to measure sun intensity in real time and monitor total daily sun exposure. Even better, it is able to provide sun protection advice via smartphone app based on your habits and skin type, get notifications when you need to apply SPF, wear a hat, or put on sunglasses…

Made by Netatmo, the bracelet is called "June" and may be beneficial for those individuals who are prone to sunburn,  out in the sun a lot, and/or concerned about skin cancer due to UV exposure.

It comes in three different colors and will soon be available for purchase.

Watch a video about this product.

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iPhone App to Objectively Measure Vocal Quality (f0, shimmer, jitter, etc)

For the inner geek in all singers and other professional voice users, you can now download onto your iPhone an advanced voice analysis program that provides objective measures of vocal quality similar to what is obtained in a professional voice laboratory.

Called OperaVox, preliminary studies have shown good reliability compared to KayPentax Multidimensional Voice Program (f0, shimmer, jitter). Noise to harmonic ratio showed less reliability. Retest reliability was also fairly consistent in all parameters.

Developed by a team of British researchers including an ENT and an audio specialist, there are 3 version of this app including a free "lite" version, a full-featured version meant for one person, and a much more expensive multi-user version meant for professionals.

The free "lite" version provides a recording of pitch f0, jitter, and shimmer as well as a history of your last 3 tests on a graph over time.

The paid full-featured version additionally also records MPT (maximum phonation time), reading measures (pitch range, mean pitch), and singing pitch range. Historical data is presented without any limits.

The multi-user version is really applicable to professionals in order to track more than one patient/student.

For the serious voice user, this app is a worthwhile investment to objectively measure your vocal quality progress (i.e., singers) as well as to provide helpful information to a speech/voice pathologist and physician when things suddenly change or get worse.

Watch video below on how this program works.

References:
Presentation by Dr Marina Mat-Baki et al from University college London and the Royal National Throat Nose and Ear Hospital, London at Cutting Edge Laryngology 2013; “Reliability of OperaVOX as acoustic analysis software: preliminary results”

Presentation by Dr Emily Lin and Jeremy Hornibrook from the University of Canterbury, New Zealand on the suitability of the iPhone microphones for performing acoustic analyses.

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ENT Doctor iPhone App Games

This was bound to happen sooner or later… thanks to @hobsonent who brought this to my attention.

This Nose Doctor iPhone app game basically is to try and remove nasal hair as well as boogers from different characters' noses using different instruments.

Another iPhone app game is Ear Doctor which deals more with ear problems (obviously).

Although these iPhone apps makes a game out of it, do ENT doctors actually professionally remove boogers, earwax, and nasal hair? We do… Regularly… For real… We are indeed professional ear and nose-pickers.

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Accurate Hearing Testing Using an iPhone

There is an iPhone app called "EarTrumpet" that apparently can provide accurate hearing testing... almost as good as a professionally administered test (conventional audiometry) and certainly as good (if not better) than medical-quality automated testing machines (ie Otogram).

Created with the assistance of the ENT department at the University of California, Irvine...

According to one study, this iPhone application provided results as good as one administered by an audiologist:

• 96% of the threshold values when obtained in a sound booth
• 94% of the threshold values when testing was done in just a "quiet" room

When accuracy was defined as "within 10 dB of the corresponding threshold value obtained using conventional audiometry."

Given how accurately the iPhone application performs, it may potentially be a very helpful screening tool to evaluate patients with ear/hearing complaints. If the testing comes back normal hearing (between 0-20db at ALL frequencies), than the patient probably hears just fine.

However, if there's any hearing loss detected, it is advised to seek professional opinion because there  are weaknesses to this program and further testing WILL be necessary.

• It ONLY performs air conduction testing. Given the lack of bone conduction testing, pure nerve testing is not possible, especially when hearing loss is detected. For example, the iPhone application will not be able to test hearing loss due to earwax/fluid versus actual nerve hearing loss.
• Speech audiometry is not present. Only pure tone audiometry. Speech audiometry provides information regarding how well spoken words are understood... one can potentially "hear" a beep at a specific frequency just fine, but still mishear a spoken word which is composed of many different sound frequencies.
• As it pertains to this research study, while there was excellent agreement in masked threshold values between the iPhone app and conventional audiometry, the sample size was limited. Masking is especially important when significant asymmetric hearing loss is present.

There may also be potential bias with the research. The developer of the EarTrumpet iPhone app, Allen Foulad, is also the lead researcher of the paper. It would be worthwhile to have other independent labs reproduce and verify the findings.

However, I applaud Dr. Foulad for his work in this area as well as entrepreneurial spirit!

You can download his app here.

As a bonus, this iPhone application can also act as a personal sound amplifier. It can enhance environmental sounds via earphones attached to the iPhone.


Reference:
Automated Audiometry Using Apple iOS-Based Application Technology. Otolaryngol Head Neck Surg. 2013 Aug 20. [Epub ahead of print]

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How To Create a Customized Fancy Email Signature

Have you ever wondered how some people obtained those really fancy looking email signatures at the end of their emails? I've always wondered how they did that as well. And until recently, I just looked on with envy until I took the time to figure it out. Here's an image of one I created for myself:

So how did I do it?

Well, there's the free way and the not-free way.

Of course, the not-free way is perhaps the easiest way to obtain a fancy email signature. Wisestamp is perhaps the best known one. Though they have a limited free version, more customization is possible if you pay a subscription fee. The other major downside (as of 1/6/13) is that there's no support for the Mac mail.app that I use 99% of the time for emails.

Than there is the free way (or ONLY way if you are a Mac mail.app user) which is the direction I took. It takes a bit more time and effort along with some basic HTML programming knowledge, but you can make it exactly the way you want it to appear.

To understand how to create customized email signatures yourself, I introduce you to Timmy Cai who has taken the time to write a how-to blog article. He also offers a service to make one for you for a single one-time set fee rather than a subscription.

In any case, here are his how-to articles depending on what email program you use:

• Gmail
• Mac Microsoft Outlook 2011
• Mac Microsoft Outlook 2010
• Mac mail.app (OS 10.8)
• Mac mail.app (OS 10.7) 
• Mac mail.app (OS 10.6)

Enjoy!

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Find an ENT Doctor App

If you have an iPhone or Android, get the ENTLink App... You can search for an ENT by current location or by zip code. The search can be narrowed to a specific specialty area (laryngology, neuro-otology, rhinology, etc) as well.

Of course, you can search for the same information from the website.

Download the app for iPhone and Android.

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Phone App That Measures How Loudly You Listen to Your Music!

There are plenty of sound meters in the market for iPhone and Android smartphones that tell a user how  loud the surrounding noise is. Many of these apps are free.

However, rather than recording the loudness of the surrounding environment, there is now a new phone app called Safe and Sound (only for Android phones) that measures the decibel level of the sound emitted from headphones and gives the user a clear indication of how loud their music really is. Furthermore, it also records the user's listening history and alerts them when they are close to their daily recommended dose of noise exposure.

It is free as well!

Listening to loud music has become an increasing concern as hearing loss is being seen at earlier and earlier ages with increasing need for hearing aids. Complaints of tinnitus is also present.

Download the app here.

Developer website.

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