Evidence map›Paper›PMID 39363661›Full record

ArticleThe Laryngoscope2025

Development of Machine Learning Copilot to Assist Novices in Learning Flexible Laryngoscopy.

Mattea E Miller, Dan Witte, Ioan Lina, Jonathan Walsh, Anaïs Rameau, Nasir I Bhatti

Abstract read
In one paragraph

Article in The Laryngoscope, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 2 papers.

0numbers the graph read from it
0cells of the map it votes in
2citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

2 citing papers in PubMed.

  1. Designing self-assessment tools for learning five instrumental clinical procedures in ENT: A modified Delphi consensus approach.European archives of oto-rhino-laryngology : official journal of the European Federation of Oto-Rhino-Laryngological Societies (EUFOS) : affiliated with the German Society for Oto-Rhino-Laryngology - Head and Neck Surgery · 2026
    Article
  2. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

6 authors.

Mattea E MillerDepartment of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.ORCID 0000-0001-5649-9996
Dan WittePerceptron Health, Inc, New York, New York, U.S.A.
Ioan LinaDepartment of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.ORCID 0000-0002-8619-7312
Jonathan WalshDepartment of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.ORCID 0000-0001-9604-6721
Anaïs RameauDepartment of Otolaryngology - Head and Neck Surgery, Sean Parker Institute for the Voice, Weill Cornell Medical College, New York, New York, U.S.A.ORCID 0000-0003-1543-2634
Nasir I BhattiDepartment of Otolaryngology-Head and Neck Surgery, Johns Hopkins School of Medicine, Baltimore, Maryland, USA.ORCID 0000-0002-3355-0549

Funding

Bridge2AI: Voice as a Biomarker of Health - Building an ethically sourced, bioaccoustic database to understand disease like never beforeOT2OD032720 · OD · UNIVERSITY OF SOUTH FLORIDA · PI BENSOUSSAN, YAEL EMILIE, BÉLISLE-PIPON, JEAN-CHRISTOPHE · 2022 to 2025
$18.0M
Developing an App-Based Voice Clinical Decision Support Tool to Augment the Sensitivity of the Bedside Swallow Evaluation in Older AdultsK76AG079040 · NIA · WEILL MEDICAL COLL OF CORNELL UNIV · PI Anais Rameau · 2022 to 2026
$972k
An AI assistance tool to guide novice practitioners in the competent performance of flexible video laryngoscopyR41EB034186 · NIBIB · PERCEPTRON HEALTH, INC. · PI BHATTI, NASIR ISLAM, WITTE, DAN · 2022 to 2022
$276k
National Institute for Biomedical Imaging and Bioengineering 1R41EB034186-01NIA NIH HHS K76 AG079040NIBIB NIH HHS R41 EB034186NIH HHS OT2 OD032720ODCDC CDC HHS OT2 OD032720
6 · The paper itself

Abstract

objectivesHere we describe the development and pilot testing of the first artificial intelligence (AI) software "copilot" to help train novices to competently perform flexible fiberoptic laryngoscopy (FFL) on a mannikin and improve their uptake of FFL skills.

methodsSupervised machine learning was used to develop an image classifier model, dubbed the "anatomical region classifier," responsible for predicting the location of camera in the upper aerodigestive tract and an object detection model, dubbed the "anatomical structure detector," responsible for locating and identifying key anatomical structures in images. Training data were collected by performing FFL on an AirSim Combo Bronchi X mannikin (United Kingdom, TruCorp Ltd) using an Ambu aScope 4 RhinoLaryngo Slim connected to an Ambu® aView™ 2 Advance Displaying Unit (Ballerup, Ambu A/S). Medical students were prospectively recruited to try the FFL copilot and rate its ease of use and self-rate their skills with and without the copilot.

resultsThis model classified anatomical regions with an overall accuracy of 91.9% on the validation set and 80.1% on the test set. The model detected anatomical structures with overall mean average precision of 0.642. Through various optimizations, we were able to run the AI copilot at approximately 28 frames per second (FPS), which is imperceptible from real time and nearly matches the video frame rate of 30 FPS. Sixty-four novice medical students were recruited for feedback on the copilot. Although 90.9% strongly agreed/agreed that the AI copilot was easy to use, their self-rating of FFL skills following use of the copilot were overall equivocal to their self-rating without the copilot.

conclusionsThe AI copilot tracked successful capture of diagnosable views of key anatomical structures effectively guiding users through FFL to ensure all anatomical structures are sufficiently captured. This tool has the potential to assist novices in efficiently gaining competence in FFL. LEVEL OF EVIDENCE: NA Laryngoscope, 135:1046-1053, 2025.

Indexed as

Clinical CompetenceLaryngoscopyMachine LearningFiber Optic TechnologyHumansManikinsPilot ProjectsProspective StudiesSoftwareAIcompetenceflexible laryngoscopymachine learningsurgical education

Identifiers

PMID39363661
PMCPMC11832335

What OpenQuestion holds

Textmetadata
LicenceTDM
Read underepoch 390

Registered trials

None linked

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.