An ensemble approach for classification of tympanic membrane conditions using soft voting classifier

Abstract Otitis media is a medical concept that represents a range of inflammatory middle ear disorders. The high costs of medical devices utilized by field experts to diagnose the disease relevant to otitis media prevent the widespread use of these devices. This makes it difficult for field experts to make an accurate diagnosis and increases subjectivity in diagnosing the disease. To solve these problems, there is a need to develop computer-aided middle ear disease diagnosis systems. In this study, a deep learning-based approach is proposed for the detection of OM disease to meet this emerging need. This approach is the first that addresses the performance of a voting ensemble framework that uses Inception V3, DenseNet 121, VGG16, MobileNet, and EfficientNet B0 pre-trained DL models. All pre-trained CNN models used in the proposed approach were trained using the Public Ear Imagery dataset, which has a total of 880 otoscopy images, including different eardrum cases such as normal, earwax plug, myringosclerosis, and chronic otitis media. The prediction results of these models were evaluated with voting approaches to increase the overall prediction accuracy. In this context, the performances of both soft and hard voting ensembles were examined. Soft voting ensemble framework achieved highest performance in experiments with 98.8% accuracy, 97.5% sensitivity, and 99.1% specificity. Our proposed model achieved the highest classification performance so far in the current dataset. The results reveal that our voting ensemble-based DL approach showed quite high performance for the diagnosis of middle ear disease. In clinical applications, this approach can provide a preliminary diagnosis of the patient's condition just before field experts make a diagnosis on otoscopic images. Thus, our proposed approach can help field experts to diagnose the disease quickly and accurately. In this way, clinicians can make the final diagnosis by integrating automatic diagnostic prediction with their experience.