Peer Review #2 of "Otitis media detection using tympanic membrane images with a novel multi-class machine learning algorithm (v0.1)"

Abstract

Background: Otitis media (OM) is the infection and inflammation of the mucous membrane covering the Eustachian with the airy cavities of the middle ear and temporal bone. OM is also one of the most common ailments. In clinical practice, the diagnosis of OM is carried out by visual inspection of otoscope images. This vulnerable process is subjective and error-prone.Methods: In this study, a novel computer-aided decision support model based on the convolutional neural network (CNN) has been developed. To improve the generalized ability of the proposed model, a combination of the channel and spatial model (CBAM), residual blocks, and hypercolumn technique is embedded into the proposed model. All experiments were performed on an open-access tympanic membrane dataset that consists of 956 otoscopes images collected into five classes. Results:The proposed model yielded satisfactory classification achievement. The model ensured an overall accuracy of 98.26%, sensitivity of 97.68%, and specificity of 99.30%. The proposed model produced rather superior results compared to the pre-trained CNNs such as AlexNet, VGG-Nets, GoogLeNet, and ResNets. Consequently, this study points out that the CNN model equipped with the advanced image processing techniques is useful for OM diagnosis. The proposed model may help to field specialists in achieving objective and repeatable results, decreasing misdiagnosis rate, and supporting the decision-making processes.