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Revista Chilena de Pediatria Aug 2020Lung auscultation is an essential part of the physical examination for diagnosing respiratory diseases. The terminology standardization for lung sounds, in addition to... (Review)
Review
Lung auscultation is an essential part of the physical examination for diagnosing respiratory diseases. The terminology standardization for lung sounds, in addition to advances in their analysis through new technologies, have improved the use of this technique. However, traditional auscultation has been questioned due to the limited concordance among health professionals. Despite the revolu tionary use of new diagnostic tools of imaging and lung function tests allowing diagnostic accuracy in respiratory diseases, no technology can replace lung auscultation to guide the diagnostic process. Lung auscultation allows identifying those patients who may benefit from a specific test. Moreover, this technique can be performed many times to make clinical decisions, and often with no need for- complicated and sometimes unavailable tests. This review describes the current state-of-the-art of lung auscultation and its efficacy based on the current respiratory sound terminology. In addition, it describes the main evidence on respiratory sound concordance studies among health professionals and its objective analysis through new technology.
Topics: Adolescent; Auscultation; Child; Child, Preschool; Clinical Decision-Making; Humans; Infant; Infant, Newborn; Observer Variation; Pediatrics; Respiratory Sounds; Terminology as Topic
PubMed: 33399725
DOI: 10.32641/rchped.v91i4.1465 -
Clinical Anatomy (New York, N.Y.) Jan 2017Proficiency in heart auscultation continues to be important even in an era of modern technology. However, many physicians and health care providers are uncomfortable and... (Review)
Review
Proficiency in heart auscultation continues to be important even in an era of modern technology. However, many physicians and health care providers are uncomfortable and often inaccurate in their ability to identify normal and abnormal heart sounds. The following review was performed to provide a basis that health care providers can use to strengthen their understanding and improve their techniques when auscultating the human heart. Clin. Anat. 30:58-60, 2017. © 2016 Wiley Periodicals, Inc.
Topics: Diastole; Heart; Heart Auscultation; Heart Sounds; Humans; Systole
PubMed: 27576554
DOI: 10.1002/ca.22780 -
Tidsskrift For Den Norske Laegeforening... Feb 2001Auscultation of the lungs has been a central element in clinical examination since the early part of the nineteenth century. However, the role of the stethoscope in our... (Review)
Review
Auscultation of the lungs has been a central element in clinical examination since the early part of the nineteenth century. However, the role of the stethoscope in our diagnostic work-up has more and more been challenged by newer diagnostic equipment. Research carried out over the last 30 years has given us new knowledge about the physical basis of lung sounds and the meaning of the sounds. Electronic stethoscopes and computer-based analysis of digital lung sounds are now available. Lungs auscultation findings should be interpreted with caution and be related to the case history and other clinical findings.
Topics: Auscultation; Diagnosis, Computer-Assisted; History, 18th Century; History, 19th Century; History, 20th Century; Humans; Lung; Respiratory Sounds; Stethoscopes
PubMed: 11255861
DOI: No ID Found -
European Heart Journal Mar 2021
Topics: Auscultation; Diagnostic Imaging; Heart; Heart Auscultation; Heart Murmurs; Humans
PubMed: 33729512
DOI: 10.1093/eurheartj/ehaa925 -
Annals of Emergency Medicine Sep 2021
Topics: Auscultation; Heart; Heart Auscultation; Humans
PubMed: 34420562
DOI: 10.1016/j.annemergmed.2021.05.007 -
The New Zealand Medical Journal Apr 1979
Topics: Auscultation; History, 19th Century; History, 20th Century; Humans; Lung; Lung Diseases
PubMed: 377157
DOI: No ID Found -
Biomedical Engineering Online Sep 2022With the spread of COVID-19, telemedicine has played an important role, but tele-auscultation is still unavailable in most countries. This study introduces and tests a...
BACKGROUND
With the spread of COVID-19, telemedicine has played an important role, but tele-auscultation is still unavailable in most countries. This study introduces and tests a tele-auscultation system (Stemoscope) and compares the concordance of the Stemoscope with the traditional stethoscope in the evaluation of heart murmurs.
METHODS
A total of 57 patients with murmurs were recruited, and echocardiographs were performed. Three cardiologists were asked to correctly categorize heart sounds (both systolic murmur and diastolic murmur) as normal vs. abnormal with both the Stemoscope and a traditional acoustic stethoscope under different conditions. Firstly, we compared the in-person auscultation agreement between Stemoscope and the conventional acoustic stethoscope. Secondly, we compared tele-auscultation (recorded heart sounds) agreement between Stemoscope and acoustic results. Thirdly, we compared both the Stemoscope tele-auscultation results and traditional acoustic stethoscope in-person auscultation results with echocardiography. Finally, ten other cardiologists were asked to complete a qualitative questionnaire to assess their experience using the Stemoscope.
RESULTS
For murmurs detection, the in-person auscultation agreement between Stemoscope and the acoustic stethoscope was 91% (p = 0.67). The agreement between Stemoscope tele-auscultation and the acoustic stethoscope in-person auscultation was 90% (p = 0.32). When using the echocardiographic findings as the reference, the agreement between Stemoscope (tele-auscultation) and the acoustic stethoscope (in-person auscultation) was 89% vs. 86% (p = 1.00). The system evaluated by ten cardiologists is considered easy to use, and most of them would consider using it in a telemedical setting.
CONCLUSION
In-person auscultation and tele-auscultation by the Stemoscope are in good agreement with manual acoustic auscultation. The Stemoscope is a helpful heart murmur screening tool at a distance and can be used in telemedicine.
Topics: Auscultation; COVID-19; Electronics; Heart Auscultation; Heart Murmurs; Humans; Stethoscopes
PubMed: 36068509
DOI: 10.1186/s12938-022-01032-4 -
Clinical Rehabilitation Feb 2016To systematically review the available evidence for the reliability and validity of cervical auscultation in diagnosing the several aspects of dysphagia in adults and... (Review)
Review
OBJECTIVE
To systematically review the available evidence for the reliability and validity of cervical auscultation in diagnosing the several aspects of dysphagia in adults and children suffering from dysphagia.
DATA SOURCES
Medline (PubMed), Embase and the Cochrane Library databases.
REVIEW METHODS
The systematic review was carried out applying the steps of the PRISMA-statement. The methodological quality of the included studies were evaluated using the Dutch 'Cochrane checklist for diagnostic accuracy studies'.
RESULTS
A total of 90 articles were identified through the search strategy, and after applying the inclusion and exclusion criteria, six articles were included in this review. In the six studies, 197 patients were assessed with cervical auscultation. Two of the six articles were considered to be of 'good' quality and three studies were of 'moderate' quality. One article was excluded because of a 'poor' methodological quality. Sensitivity ranges from 23%-94% and specificity ranges from 50%-74%. Inter-rater reliability was 'poor' or 'fair' in all studies. The intra-rater reliability shows a wide variance among speech language therapists.
CONCLUSION
In this systematic review, conflicting evidence is found for the validity of cervical auscultation. The reliability of cervical auscultation is insufficient when used as a stand-alone tool in the diagnosis of dysphagia in adults. There is no available evidence for the validity and reliability of cervical auscultation in children. Cervical auscultation should not be used as a stand-alone instrument to diagnose dysphagia.
Topics: Adult; Auscultation; Child; Data Mining; Databases, Bibliographic; Deglutition Disorders; Humans; Reproducibility of Results; Validation Studies as Topic
PubMed: 25792689
DOI: 10.1177/0269215515576779 -
MedEdPORTAL : the Journal of Teaching... Mar 2021Mastery of respiratory auscultation skills is fundamental for clinicians to develop. We created a case-based educational session utilizing a high-fidelity simulator to...
INTRODUCTION
Mastery of respiratory auscultation skills is fundamental for clinicians to develop. We created a case-based educational session utilizing a high-fidelity simulator to teach lung sound auscultation to medical students at our institution. We employed a hypothesis-driven approach and deliberate practice to enhance students' learning experience and retention of acquired skills.
METHODS
We developed the session to teach second-year medical students how to discriminate between normal and pathological respiratory sounds within the context of clinical vignettes. Faculty facilitators, in conjunction with near-peer educators, made use of a high-fidelity auscultation manikin to guide students through case-based problem sets. Students were given the opportunity to auscultate the manikin while being observed and receiving feedback from the faculty.
RESULTS
We introduced the manikin in 2016, with a total of 759 second-year medical students from four class years having participated in the session since then. Students evaluated the session through an end-of-the-week and end-of-unit survey. The survey showed an overall improvement in learner satisfaction over previous years. Survey results and feedback were used to make adjustments to the session.
DISCUSSION
Our respiratory auscultation session was well received overall. Proper faculty development is crucial for implementing the session. Because of the focus on deliberate practice, adequate time must be allotted to hold the session. This program is reproducible with similar high-fidelity simulators.
Topics: Auscultation; Clinical Competence; Computer Simulation; Humans; Manikins; Students, Medical
PubMed: 33768144
DOI: 10.15766/mep_2374-8265.11107 -
Annals of Internal Medicine Jun 2000
Topics: Auscultation; Clothing; Humans; Time Factors
PubMed: 10858160
DOI: 10.7326/0003-4819-132-12-200006200-00024