Table 5a.

Diagnostic studies conducted in LMIC or disadvantaged populations.

Country	Study Population	Method of diagnosis	Reference
Australia (Aborigine populations)	1699 children (aged 0–17years)	Age appropriate audiometry, tympanometry, standard and pneumatic video-otoscopy	Gunasekera 2018
Philippines	47 children (aged less than 18 years)	Operating otoscope, video otoscope, tympanometry, distortion product otoacoustic emission, audiometry screening using noise cancelling headphones and a handheld Android device	Chan 2019
Ethiopia	173	Ear discharge, otoscope with headlights where available otherwise naked eye was employed	Gorems 2018
Indonesia	36 (17–50 years)	Persistent or recurrence of ear discharge for more than 2 months, perforated tympanic membrane and negative findings of cholesteatoma from physical examination or radiological examination	Darmawan 2018
India	3000 patients	(ENTraview A store-and-forward telemedicine device that integrates a camera-enabled smart phone with an otoscope)	Gupta 2017
		Commercial video otoscopes	Myburgh 2016
Yemen	150 children	Ear discharge	Bin Mohanna 2016
India	30 patients (15–45 years)	History taking, clinical examination, pure tone audiometry, X-ray examination of mastoids	Santesh 2016
Nigeria	3021 Children (less than 18 years)	Medical history and auroscopy	Ilechukwu 2016
Malawi	104 patients with mean age 17.8	Detailed clinical history, including duration of discharge	Chirwa 2015
Iran	62 adults	Thorough medical history, physical examination including anterior rhinoscopy and otoscopy. History of chronic otorrhoea (persisting for at least 3 months), accumulation of mucopurulent exudates in the external canal or middle ear and/or perforated tympanic membrane on otoscopy.	Nemati 2015
Tanzania	301 adult patients	Medical history, otoscopy, Rinne’s test, Weber’s test for assessment of hearing loss. Discharge for more than 6 weeks, tympanic membrane perforation	Mushi 2016
India	502 patients	tympanomastoidectomy	Kameswaran 2017