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Tubercle Jun 1981
Topics: Auscultation; France; History, 19th Century; Humans; Tuberculosis
PubMed: 7029837
DOI: 10.1016/0041-3879(81)90026-x -
Neurological Research Oct 2002Carotid bruits are supposed to indicate the presence of high-grade common carotid or extracranial internal carotid artery stenosis in a large proportion of patients....
Carotid bruits are supposed to indicate the presence of high-grade common carotid or extracranial internal carotid artery stenosis in a large proportion of patients. Using a stethoscope, we prospectively auscultated 273 carotid arteries of 145 patients blinded to the results of a complete extracranial and intracranial Doppler investigation including extracranial color-coded duplex ultrasound. Fifty-four arteries showed stenosis of > or = 50%-99%, or occlusion of the extracranial internal or the common carotid artery. In 25 of these arteries, a bruit was present. In 9 out of 16 patients with extracranial stenosis from 70%-99%, a bruit was detected. In one additional patient with a middle-grade external carotid artery stenosis, a bruit was also present. In seven additional patients, a bruit was present in the absence of any carotid artery stenosis, cardiac vitium or goiter. The sensitivity of carotid auscultation for the detection of a 70%-99% stenosis of the common or extracranial internal carotid artery was 56% and specificity was 91%. The positive predictive value of a bruit found during carotid auscultation was 27%, and the negative predictive value of a normal auscultation was 97%. Carotid auscultation is a useful screening procedure in the detection of carotid stenosis or occlusion, but requires confirmation by carotid ultrasound.
Topics: Adult; Aged; Aged, 80 and over; Auscultation; Carotid Stenosis; Female; Humans; Male; Middle Aged; Predictive Value of Tests; Prospective Studies; Reproducibility of Results; Ultrasonography, Doppler, Duplex
PubMed: 12392209
DOI: 10.1179/016164102101200618 -
Archives of Gynecology and Obstetrics Mar 2011Auscultation of the fetal heart is a common event in antenatal care, in early pregnancy it may be associated with false negative results, which require ultrasound scan...
INTRODUCTION
Auscultation of the fetal heart is a common event in antenatal care, in early pregnancy it may be associated with false negative results, which require ultrasound scan to confirm fetal viability.
METHODS
We studied 197 women in early pregnancy to determine the gestational age at which the fetal heart can be reliably identified and the factors which determined the accuracy of the test.
RESULTS
The proportion of successful auscultations increased with advancing gestation (p < 0.001). There was no effect of maternal body mass index or the level of midwifery experience.
CONCLUSION
For a sensitivity of 90%, the fetal heart should be auscultated after 13 week gestation. If a sensitivity of 80% is acceptable the fetal heart can be auscultated after 12 + 1 week gestation.
Topics: Adolescent; Adult; Female; Fetal Heart; Gestational Age; Heart Auscultation; Humans; Pregnancy; Pregnancy Trimester, First; Pregnancy Trimester, Second; Prospective Studies; Ultrasonography, Doppler; Ultrasonography, Prenatal; Young Adult
PubMed: 20617441
DOI: 10.1007/s00404-010-1563-5 -
Journal of the History of Medicine and... Apr 1978
Topics: Auscultation; Cardiology; Heart Auscultation; History, 19th Century; Humans; New York; Schools, Medical; United States
PubMed: 350956
DOI: 10.1093/jhmas/xxxiii.2.129 -
Pneumologie (Stuttgart, Germany) Jun 2016Auscultation of the lung is an inexpensive, noninvasive and easy-to-perform tool. It is an important part of the physical examination and is help ful to distinguish... (Review)
Review
Auscultation of the lung is an inexpensive, noninvasive and easy-to-perform tool. It is an important part of the physical examination and is help ful to distinguish physiological respiratory sounds from pathophysiological events. Computerized lung sound analysis is a powerful tool for optimizing and quantifying electronic auscultation based on the specific lung sound spectral characteristics. The automatic analysis of respiratory sounds assumes that physiological and pathological sounds are reliably analyzed based on special algorithms. The development of automated long-term lungsound monitors enables objective assessment of different respiratory symptoms.
Topics: Algorithms; Auscultation; Diagnosis, Computer-Assisted; Diagnosis, Differential; Humans; Lung Diseases; Respiratory Sounds; Sound Spectrography
PubMed: 27177168
DOI: 10.1055/s-0042-106155 -
Journal of Telemedicine and Telecare 2002We have developed an Internet-based tool for remote realtime auscultation. The device was based on a commercially available electronic stethoscope and a PC which...
We have developed an Internet-based tool for remote realtime auscultation. The device was based on a commercially available electronic stethoscope and a PC which digitized and transmitted the signals. A voice and video channel were also available. The remote auscultation tool was evaluated between two sites in Sweden separated by a distance of 500 km. A doctor at one of the sites performed cardiac and pulmonary auscultations on patients located at the other site. Four test patients were assisted by a nurse operating the electronic stethoscope. The auscultation sessions were performed with and without video support to assess the importance of visual contact between doctor and patient. Twenty sessions were conducted (excluding technical testing to solve problems with the equipment). Audio quality was sufficient, as judged subjectively by the doctors concerned. Video support improved the doctor s confidence that the stethoscope was being operated properly and greatly simplified the interaction. Moreover, it improved all participants subjective impression of the virtual meeting. Our work demonstrates the feasibility of performing remote auscultation sessions over the Internet.
Topics: Auscultation; Feasibility Studies; Home Care Services; Humans; Internet; Remote Consultation; Stethoscopes; Sweden
PubMed: 12217131
DOI: 10.1177/1357633X020080S220 -
Likars'ka Sprava 1996
Topics: Auscultation; Equipment Design; Humans; Stethoscopes
PubMed: 9377383
DOI: No ID Found -
La Presse Medicale Dec 1960
Topics: Auscultation; Equipment and Supplies
PubMed: 14448095
DOI: No ID Found -
Physical Therapy Dec 1995Although auscultation is routinely used in the assessment of respiratory status, the ability of the rater to accurately and consistently identify lung sounds has been...
BACKGROUND AND PURPOSE
Although auscultation is routinely used in the assessment of respiratory status, the ability of the rater to accurately and consistently identify lung sounds has been questioned. The literature on this issue is sparse and has focused on reliability of auscultation of tape-recorded rather than in vivo lung sounds. The purposes of this study were to determine the interrater reliability of physical therapists in the direct auscultation of lung sounds based on their clinical experience in chest physical therapy and to determine whether the adoption of standardized nomenclature and education on proper technique and interpretation affects reliability.
SUBJECTS AND METHODS
A group of 57 registered physical therapists were stratified by clinical experience into four groups. Sixteen therapists (ie, 4 in each stratum) were randomly chosen using a random number table. The following criteria were developed to delineate clinical experience. Group 1 subjects were senior chest physical therapists with at least 5 years of experience in this area of practice. Group 2 subjects were experienced therapists who had a minimum of 2 years of experience in chest physical therapy and were currently practicing in this area. Group 3 subjects were experienced physical therapists in other areas who were also practicing in chest physical therapy on occasional weekend service. Group 4 subjects were new graduates. Ten patients were evaluated by each group of 4 physical therapists using a teaching stethoscope with one diaphragm/bell and four pairs of earpieces. The education session consisted of discussion of the adoption of standardized nomenclature and education on proper technique and interpretation of auscultation. Interrater reliability was assessed before and after the education session using kappa (kappa) values. Comparisons were made between kappa values before and after the education session to determine the effect of education and between groups to determine the effect of clinical experience.
RESULTS
The kappa values before the education session were low, indicating poor reliability in detecting specific abnormal sounds (kappa = -.02-.59). Group 1 (seniors in respiratory therapy) and group 4 (new graduates) demonstrated the greatest reliability levels. The lowest kappa values were observed for detecting and categorizing the quality of breath sounds (normal, absent, bronchial, or decreased) (kappa = -.02-.25). Following the education session, there was a general improvement in reliability (kappa = -.30-.77), especially for group 3 (specialists in other areas). The most improvement was noted for the detection of the quality of breath sounds (kappa = .08-.50).
CONCLUSION AND DISCUSSION
Reliability of auscultation was poor to fair, in general, before the education session. There was a definite improvement in reliability after the education session. There was no clear effect of clinical experience on reliability, and the agreement among observers appeared to depend on the abnormal lung sound present. Limitations of this study and recommendations for future research are discussed. [Brooks D, Thomas J. Interrater reliability of auscultation of breath sounds among physical therapists.
Topics: Auscultation; Clinical Competence; Education, Continuing; Humans; Observer Variation; Physical Therapy Modalities; Program Evaluation; Reproducibility of Results; Respiratory Sounds; Respiratory Therapy; Terminology as Topic
PubMed: 7501711
DOI: 10.1093/ptj/75.12.1082 -
PeerJ 2024During the COVID-19 pandemic, universal mask-wearing became one of the main public health interventions. Because of this, most physical examinations, including lung...
OBJECTIVE
During the COVID-19 pandemic, universal mask-wearing became one of the main public health interventions. Because of this, most physical examinations, including lung auscultation, were done while patients were wearing surgical face masks. The aim of this study was to investigate whether mask wearing has an impact on pulmonologist assessment during auscultation of the lungs.
METHODS
This was a repeated measures crossover design study. Three pulmonologists were instructed to auscultate patients with previously verified prolonged expiration, wheezing, or crackles while patients were wearing or not wearing masks (physician and patients were separated by an opaque barrier). As a measure of pulmonologists' agreement in the assessment of lung sounds, we used Fleiss kappa (K).
RESULTS
There was no significant difference in agreement on physician assessment of lung sounds in all three categories (normal lung sound, duration of expiration, and adventitious lung sound) whether the patient was wearing a mask or not, but there were significant differences among pulmonologists when it came to agreement of lung sound assessment.
CONCLUSION
Clinicians and health professionals are safer from respiratory infections when they are wearing masks, and patients should be encouraged to wear masks because our research proved no significant difference in agreement on pulmonologists' assessment of auscultated lung sounds whether or not patients wore masks.
Topics: Humans; Masks; COVID-19; Cross-Over Studies; Auscultation; Male; Respiratory Sounds; Female; SARS-CoV-2; Middle Aged; Adult; Pandemics; Pulmonologists; Aged
PubMed: 38803582
DOI: 10.7717/peerj.17368