Questionnaires and participants
We generated 10 online questionnaires on Qualtrics (www.qualtrics.com),
each containing 18 images out of the image set of 60 images, balanced
regarding the three different imaging techniques and presence of
cholesteatoma or not (Table 1). We chose 18 images per questionnaire in
order to complete the questionnaire in an acceptable time and therefore
receive more responses overall, while still allowing a solid statistical
analysis. All 60 images were used and every image was present in three
different questionnaires.
Thereafter, we reached out to ear surgeons with expertise in
cholesteatoma surgery to rate the images regarding the presence of
cholesteatoma or not. No additional detailed instructions were sent to
the participants. The image enhancement technique was indicated on every
image. Moreover, general information (age, gender), details regarding
the surgical experience (microscopic and endoscopic ear surgery) as well
as subjective preferences regarding the three different imaging
modalities were assessed (usefulness on a scale from 1-5 and single
choice for one of the three imaging techniques). The study participants
were randomly assigned to a questionnaire. After a few weeks, we asked
participants to complete the same questionnaire for a second time.