Key Points: 1. Efforts to combat the large global burden of ear and hearing disorders are hampered by poor availability of expert diagnosis 2. We report the first study to directly compare prediction model, non-expert and tele-diagnosis of middle and external ear disorders. 3. A prediction model based upon a novel automated otological symptom questionnaire performed poorly, but absence of otorrhoea was found to reliably exclude a diagnosis of chronic suppurative otitis media. 4. Both on-site non-expert and expert tele-diagnosis had high diagnostic specificity, but low sensitivity. 5. Future work could explore how the validity of these diagnostic methods may be improved.