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The Journal of Emergency Medicine Oct 2022Auscultation for an extended period of time using a wearable stethoscope enables objective computerized analysis and longitudinal assessment of lung sounds. However,...
BACKGROUND
Auscultation for an extended period of time using a wearable stethoscope enables objective computerized analysis and longitudinal assessment of lung sounds. However, this auscultation method differs from bedside auscultation in that clinicians are not present to optimize the quality of auscultation. No prior studies have compared these two auscultation methods.
OBJECTIVE
The aim of this study was to compare intermittent auscultation using a conventional stethoscope with continuous auscultation using a wearable stethoscope for wheeze detection in patients who present with acute respiratory distress.
METHODS
Patients presenting to the emergency department with acute respiratory distress were enrolled. The Strados Remote Electronic Stethoscope Platform (RESP™) was used for continuous auscultation, and intermittent auscultation was performed using a U.S. Food and Drug Administration-cleared electronic stethoscope. A recording was made with an electronic stethoscope. Subsequently, continuous recording was made using RESP™, which continued until the patient was admitted or discharged from the emergency department. The number of captured wheezes in each recording was counted and validated by two board-certified physicians.
RESULTS
From May 2018 to May 2019, 43 patients were enrolled in the study. Three patients were excluded from analysis due to incomplete audio recording data. The mean length of recording was 62.3 min for continuous auscultation and 0.7 min for intermittent auscultation; 77.5% (31 of 40) of intermittent recordings contained wheezes, in contrast to 85% (34 of 40) of continuous recordings.
CONCLUSIONS
Extending the duration of auscultation using a wearable stethoscope in a noisy clinical environment showed comparable performance to standard of care intermittent auscultation in identifying patients who have wheezes.
Topics: Humans; Respiratory Sounds; Auscultation; Stethoscopes; Respiratory Distress Syndrome
PubMed: 36244855
DOI: 10.1016/j.jemermed.2022.07.001 -
Revue Des Maladies Respiratoires Jun 2008Distinction between normal and abnormal respiratory sounds is important for accurate diagnosis. (Comparative Study)
Comparative Study Review
BACKGROUND
Distinction between normal and abnormal respiratory sounds is important for accurate diagnosis.
CURRENT DATA
This paper describes the state of the art, scientific publications and ongoing research related to the respiratory sounds. The study includes a description of the various techniques that are being used to record auscultatory sounds and a physical description of known pathological sounds (wheezes and crackles) for which automatic detection tools have been developed.
VIEWPOINTS
The next stage will include exploiting all the qualities of the sounds. This augmentation of the spectrum studied, linked to signal analysis techniques, will allow the definition of new characteristic markers.
Topics: Acoustics; Asthma; Auscultation; Cough; Evidence-Based Medicine; Humans; Respiratory Sounds; Sound Spectrography; Stethoscopes
PubMed: 18772825
DOI: 10.1016/s0761-8425(08)73797-5 -
The New England Journal of Medicine Feb 1970
Topics: Auscultation; Humans
PubMed: 5410825
DOI: 10.1056/NEJM197002052820617 -
British Journal of Nursing (Mark Allen...This article considers national policy drivers promoting the development of advanced assessment skills and practical procedures for the safe and effective use of the... (Review)
Review
This article considers national policy drivers promoting the development of advanced assessment skills and practical procedures for the safe and effective use of the stethoscope in the clinical area. The evidence base underpinning effective use of the stethoscope in clinical practice is explored, including the preparation of the patient and the environment, applying infection control policies, and placing an emphasis on privacy and dignity. This is followed by a practical guide to auscultation technique of the respiratory system for nurses developing advanced practice skills.
Topics: Auscultation; Clinical Competence; Evidence-Based Medicine; Health Policy; Humans; Infection Control; Informed Consent; Lung; Models, Nursing; Nurse's Role; Nursing Assessment; Nursing Theory; Patient Education as Topic; Posture; Respiratory Sounds; Safety Management; Stethoscopes; United Kingdom
PubMed: 18825853
DOI: 10.12968/bjon.2008.17.12.30307 -
American Journal of Human Biology : the... Jan 2018Human biologists have been examining arterial blood pressure since they began studying the effects of the environment and culture on the health of diverse populations.... (Review)
Review
Human biologists have been examining arterial blood pressure since they began studying the effects of the environment and culture on the health of diverse populations. The Korotkoff auscultatory technique with a trained observer and aneroid sphygmomanometer is the method of choice for blood pressure measurement in many bioanthropological field contexts. Korotkoff sounds (the first and fifth phases) are the preferred determinants of systolic and diastolic pressure, even in infants, children, pregnant women, and the elderly. Training of observers, positioning of individuals, and selection of cuff size are all essential for obtaining standardized measurements. Automatic electronic devices are increasingly being used for blood pressure measurement in human biological studies. The automatic monitors often use the oscillometric method for measuring pressure, but must be validated before use. The emergence of automatic ambulatory blood pressure monitors has opened another avenue of research on blood pressure in human biology, where allostasis and circadian responses to environmental change and real life behavioral challenges can be defined and evaluated, largely because there is now the ability to make multiple measurements over time and in varying contexts. Stand-alone automatic monitors can also be substituted for manual auscultated readings in field contexts, although in studies where participants measure their own pressure, education about how the devices work and protocol specifics are necessary. Finally, computer-driven plethysmographic devices that measure pressure in the finger are available to evaluate short-term reactivity to specific challenges.
Topics: Arterial Pressure; Auscultation; Blood Pressure Determination; Blood Pressure Monitoring, Ambulatory; Humans; Oscillometry
PubMed: 28940503
DOI: 10.1002/ajhb.23063 -
Paediatric Nursing Apr 2007Nursing continues to extend its practice base as the acuity of children in general wards often with complex illnesses and treatment increases. There is a need for... (Review)
Review
Nursing continues to extend its practice base as the acuity of children in general wards often with complex illnesses and treatment increases. There is a need for ongoing development of the physical assessment skills of nurses who care for children and young people in order to facilitate early recognition of clinical problems. Respiratory dysfunction is the common precursor to adverse events. The skill of auscultation adds another dimension that augments the respiratory assessment repertoire of the nurse. This article builds on the palpation skills presented in February issue and provides a practical step-by-step introduction to auscultation.
Topics: Auscultation; Biomechanical Phenomena; Child; Humans; Respiratory Sounds; Respiratory Tract Diseases; Stethoscopes
PubMed: 17472197
DOI: 10.7748/paed2007.04.19.3.38.c4447 -
Annual International Conference of the... Jul 2020Technology is rapidly changing the health care industry. As new systems and devices are developed, validating their effectiveness in practice is not trivial, yet it is...
Technology is rapidly changing the health care industry. As new systems and devices are developed, validating their effectiveness in practice is not trivial, yet it is essential for assessing their technical and clinical capabilities. Digital auscultations are new technologies that are changing the landscape of diagnosis of lung and heart sounds and revamping the centuries old original design of the stethoscope. Here, we propose a methodology to validate a newly developed digital stethoscope, and compare its effectiveness against a market-accepted device, using a combination of signal properties and clinical assessments. Data from 100 pediatric patients is collected using both devices side by side in two clinical sites. Using the proposed methodology, we objectively compare the technical performance of the two devices, and identify clinical situations where performance of the two devices differs. The proposed methodology offers a general approach to verify a new digital auscultation device as clinically-viable; while highlighting the important consideration for clinical conditions in performing these evaluations.
Topics: Auscultation; Child; Heart Sounds; Humans; Lung; Stethoscopes; Technology
PubMed: 33018152
DOI: 10.1109/EMBC44109.2020.9176456 -
Annual International Conference of the... Jul 2022Thanks to recent advances in digital stethoscopes and rapid adoption of deep learning techniques, there has been tremendous progress in the field of Computerized...
Thanks to recent advances in digital stethoscopes and rapid adoption of deep learning techniques, there has been tremendous progress in the field of Computerized Auscultation Analysis (CAA). Despite these promising leaps, the deploy-ment of these technologies in real-world applications remains limited due to inherent challenges with properly interpreting clinical data, particularly auscultations. One of the limiting factors is the inherent ambiguity that comes with variability in clinical opinion, even from highly trained experts. The lack of unanimity in expert opinions is often ignored in developing machine learning techniques to automatically screen normal from abnormal lung signals, with most algorithms being developed and tested on highly curated datasets. To better understand the potential pitfalls this selective analysis could cause in deployment, the current work explores the impact of clinical opinion variability on algorithms to detect adventitious patterns in lung sounds when trained on gold-standard data. The study shows that uncertainty in clinical opinion introduces far more variability and performance drop than dissidence in expert judgments. The study also explores the feasibility of automatically flagging auscultation signals based on their estimated uncertainty, thereby recommending further reassessment as well as improving computer-aided analysis.
Topics: Auscultation; Computers; Humans; Lung; Respiratory Sounds; Stethoscopes
PubMed: 36086501
DOI: 10.1109/EMBC48229.2022.9871393 -
JASA Express Letters May 2024Machine learning enabled auscultating diagnosis can provide promising solutions especially for prescreening purposes. The bottleneck for its potential success is that...
Machine learning enabled auscultating diagnosis can provide promising solutions especially for prescreening purposes. The bottleneck for its potential success is that high-quality datasets for training are still scarce. An open auscultation dataset that consists of samples and annotations from patients and healthy individuals is established in this work for the respiratory diagnosis studies with machine learning, which is of both scientific importance and practical potential. A machine learning approach is examined to showcase the use of this new dataset for lung sound classifications with different diseases. The open dataset is available to the public online.
Topics: Humans; Machine Learning; Auscultation; Respiratory Sounds
PubMed: 38717466
DOI: 10.1121/10.0025851 -
The International Journal of Medical... Feb 2023Since most developed countries are facing an increase in the number of patients per healthcare worker due to a declining birth rate and an ageing population, relatively...
BACKGROUND
Since most developed countries are facing an increase in the number of patients per healthcare worker due to a declining birth rate and an ageing population, relatively simple and safe diagnosis tasks may need to be performed using robotics and automation technologies, without specialists and hospitals. This study presents an automated robotic platform for remote auscultation, which is a highly cost-effective screening tool for detecting abnormal clinical signs.
METHOD
The developed robotic platform is composed of a 6-degree-of-freedom cooperative robotic arm, LiDAR camera, and a spring-based mechanism holding an electric stethoscope. The platform enables autonomous stethoscope positioning based on external body information acquired using the LiDAR camera-based multi-way registration; the platform also ensures safe and flexible contact, maintaining the contact force within a certain range through the passive-actuated mechanism.
RESULTS
Our preliminary results confirm that the robotic platform enables estimation of the landing positions required for cardiac examinations based on the depth and landmark information of the body surface. It also handles the stethoscope while maintaining the contact force without relying on the push-in displacement by the robotic arm.
CONCLUSION
The developed robotic platform enables the estimation of the landing positions and handling the stethoscope while maintaining the contact force, which promises the potential of automatic remote auscultation.
Topics: Humans; Robotics; Auscultation; Automation; Health Personnel
PubMed: 36097703
DOI: 10.1002/rcs.2461