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Anaesthesia Feb 1983
Topics: Auscultation; Equipment Design; Humans
PubMed: 6829889
DOI: 10.1111/j.1365-2044.1983.tb13943.x -
Archives of Disease in Childhood. Fetal... Sep 2018Clinical assessment of an infant's heart rate (HR) in the delivery room (DR) has been reported to be inaccurate. We compared auscultation of the HR using a stethoscope... (Comparative Study)
Comparative Study
Clinical assessment of an infant's heart rate (HR) in the delivery room (DR) has been reported to be inaccurate. We compared auscultation of the HR using a stethoscope with electrocardiography (ECG) and pulse oximetry (PO) for determining the HR in 92 low-risk newborn infants in the DR. Caregivers auscultated the HR while masked to the HR on the monitor. Auscultation underestimated ECG HR (mean difference (95% CI) by -9 (-15 to -2) beats per minute (bpm)) and PO HR (mean difference (95% CI) by -5 (-12 to 2) bpm). The median (IQR) time to HR by auscultation was 14 (10-18) s. As HR was determined quickly and with reasonable accuracy by auscultation in low-risk newborns, study in high-risk infants is warranted.
Topics: Auscultation; Dimensional Measurement Accuracy; Electrocardiography; Female; Heart Rate; Humans; Infant, Newborn; Male; Neonatal Screening; Oximetry; Postnatal Care; Reproducibility of Results
PubMed: 29802102
DOI: 10.1136/archdischild-2017-314367 -
Methods in Molecular Biology (Clifton,... 2015iStethoscope Pro is the first piece of software (an "App") produced for iOS devices, which enabled users to exploit their smartphones, music players, or tablets as...
iStethoscope Pro is the first piece of software (an "App") produced for iOS devices, which enabled users to exploit their smartphones, music players, or tablets as stethoscopes. The software exploits the built-in microphone (and supports externally added microphones) and performs real-time amplification and filtering to enable heart sounds to be heard with high fidelity. The software also enables the heart sounds to be recorded, analyzed using a spectrogram, and to be transmitted to others via e-mail. This chapter describes the motivation, functionality, and results from this work.
Topics: Algorithms; Auscultation; Cell Phone; Heart Sounds; Humans; Internet; Signal Processing, Computer-Assisted; Software; Stethoscopes; Telemedicine
PubMed: 25626547
DOI: 10.1007/978-1-4939-2172-0_20 -
Minerva Pediatrica Jun 2019Automated detection of heart murmurs with computer-aided auscultation is not yet in clinical routine use. Aim of this study was to test sensitivity and specificity of a... (Comparative Study)
Comparative Study Observational Study
BACKGROUND
Automated detection of heart murmurs with computer-aided auscultation is not yet in clinical routine use. Aim of this study was to test sensitivity and specificity of a novel prototype algorithm in automated detection of heart murmurs from digitally recorded phonocardiograms in neonates admitted at the Neonatal Intensive Care Unit.
METHODS
In a prospective pilot observational study from November 2012 to December 2013 auscultations by pediatricians and computer aided auscultation were performed within 12 hours of neonatal echocardiography. Echocardiography was defined as pathological when resulting in any clinical consequences or causing murmur. Phonocardiograms and auscultation were defined as pathological if a murmur was detected. Phonocardiograms were analyzed offline with a novel algorithm prototype (CSD Labs, Graz, Austria) for detection of murmurs in neonates in a first run and with an optimized algorithm in a second run and were compared with echocardiography. Sensitivity and specificity of auscultation by pediatrician and computer aided auscultation were analyzed.
RESULTS
Thirty-six neonates (gestational age: 36±3 weeks) were included. Twenty-three (64%) neonates had pathological or murmur causing findings in echocardiography (positive echocardiography). Sensitivity and specificity of auscultation by pediatrician were 17% and 100%, respectively. In comparison to auscultation by pediatrician sensitivity of first run and second run were significantly higher with 70% and 83%, respectively. Specificity of first run and second run were 77% and 85%, respectively.
CONCLUSIONS
Phonocardiogram analysis using the novel algorithm prototype had a higher sensitivity than auscultation by pediatrician in detecting positive echocardiography findings in neonates.
Topics: Algorithms; Auscultation; Diagnosis, Computer-Assisted; Echocardiography; Female; Heart Murmurs; Humans; Infant, Newborn; Male; Mass Screening; Phonocardiography; Pilot Projects; Prospective Studies; Sensitivity and Specificity
PubMed: 29968444
DOI: 10.23736/S0026-4946.18.04974-5 -
Journal of the American Geriatrics... Nov 2015
Topics: Auscultation; Cachexia; Humans; Quality Improvement
PubMed: 26603083
DOI: 10.1111/jgs.13811 -
The Veterinary Record Jul 2019In practice, veterinary surgeons frequently rely on lung auscultation as a confirmation test for pneumonia. To what extent diagnostic accuracy of lung auscultation...
In practice, veterinary surgeons frequently rely on lung auscultation as a confirmation test for pneumonia. To what extent diagnostic accuracy of lung auscultation varies between different practitioners is currently unknown. In this diagnostic test study, 49 Dutch veterinarians each auscultated between 8 and 10 calves, and communicated whether they would decide to treat the animal with antimicrobials or not. They were not allowed to perform any other aspect of the clinical examination. Their decisions were compared with lung ultrasonography findings. The average sensitivity and specificity of lung auscultation were 0.63 (sd=0.2; range=0.2-1.0) and 0.46 (sd=0.3; range=0.0-1.0), respectively. Of the participants, 8.2 per cent were 100 per cent sensitive, 16.3 per cent were 100 per cent specific, and only 4.0 per cent were perfect. The Krippendorff's alpha was 0.18 (95 per cent confidence interval: -0.01 to 0.38), signifying poor reliability between multiple raters. Regardless of the poor diagnostic accuracy in this study, especially the large variation in a confirmation test between different practitioners could potentially cause professional damage as well as misuse of antimicrobials. This study could be seen as a gentle stimulus to regularly evaluate one's diagnostic skills. Both complementary training and the use of more accurate techniques with less inter-rater variation could improve the situation.
Topics: Animals; Auscultation; Cattle; Lung; Netherlands; Reproducibility of Results; Sensitivity and Specificity; Veterinarians
PubMed: 31320546
DOI: 10.1136/vr.105238 -
American Journal of Respiratory and... Sep 1997
Review
Topics: Auscultation; Forecasting; Humans; Respiratory Sounds; Signal Processing, Computer-Assisted; Stethoscopes; Transducers
PubMed: 9310022
DOI: 10.1164/ajrccm.156.3.9701115 -
Journal of Cardiology Apr 2024In the aging global society, heart failure and valvular heart diseases, including aortic stenosis, are affecting millions of people and healthcare systems worldwide.... (Review)
Review
In the aging global society, heart failure and valvular heart diseases, including aortic stenosis, are affecting millions of people and healthcare systems worldwide. Although the number of effective treatment options has increased in recent years, the lack of effective screening methods is provoking continued high mortality and rehospitalization rates. Appropriately, auscultation has been the primary option for screening such patients, however, challenges arise due to the variability in auscultation skills, the objectivity of the clinical method, and the presence of sounds inaudible to the human ear. To address challenges associated with the current approach towards auscultation, the hardware of Super StethoScope was developed. This paper is composed of (1) a background literature review of bioacoustic research regarding heart disease detection, (2) an introduction of our approach to heart sound research and development of Super StethoScope, (3) a discussion of the application of remote auscultation to telemedicine, and (4) results of a market needs survey on traditional and remote auscultation. Heart sounds and murmurs, if collected properly, have been shown to closely represent heart disease characteristics. Correspondingly, the main characteristics of Super StethoScope include: (1) simultaneous collection of electrocardiographic and heart sound for the detection of heart rate variability, (2) optimized signal-to-noise ratio in the audible frequency bands, and (3) acquisition of heart sounds including the inaudible frequency ranges. Due to the ability to visualize the data, the device is able to provide quantitative results without disturbance by sound quality alterations during remote auscultations. An online survey of 3648 doctors confirmed that auscultation is the common examination method used in today's clinical practice and revealed that artificial intelligence-based heart sound analysis systems are expected to be integrated into clinicians' practices. Super StethoScope would open new horizons for heart sound research and telemedicine.
Topics: Humans; Stethoscopes; Heart Sounds; Artificial Intelligence; Auscultation; Heart Diseases; Heart Auscultation
PubMed: 37734656
DOI: 10.1016/j.jjcc.2023.09.007 -
International Journal of Clinical... Nov 1997Although auscultation is commonly used as a continuous monitoring tool during anesthesia, the breath sounds of anesthetized patients have never been systematically...
Although auscultation is commonly used as a continuous monitoring tool during anesthesia, the breath sounds of anesthetized patients have never been systematically studied. In this investigation we used digital audio technology to record and analyze the breath sounds of 14 healthy adult patients receiving general anesthesia with positive pressure ventilation. Sounds recorded from inside the esophagus were compared to those recorded from the surface of the chest, and corresponding airflow was measured with a pneumotachograph. The sound samples associated with inspiratory and expiratory phases were analyzed in the time domain (RMS amplitude) and frequency domain (peak frequency, spectral edge, and power ratios). There was a positive linear correlation (R2 > 0.9) between inspiratory flow and sound amplitude in the precordial and esophageal samples of all patients. The RMS amplitude of the inspiratory and expiratory sounds was approximately 13 times greater when recorded from inside the esophagus than from the surface of the chest in all patients at all flows (p < 0.001). The peak frequency (Hz) was significantly higher in the esophageal recordings than the precordial samples (298 +/- 9 vs 181 +/- 10, P < 0.0001), as was the 97% spectral edge (Hz) (740 +/- 7 vs 348 +/- 16, P < 0.0001). In the adult population esophageal stethoscopes yield higher frequencies and greater amplitude than precordial stethoscopes. Quantification of lung sounds may provide for improved monitoring and diagnostic capability during anesthesia and surgery.
Topics: Adolescent; Adult; Anesthesia, General; Auscultation; Esophagus; Female; Humans; Male; Middle Aged; Respiration; Signal Processing, Computer-Assisted
PubMed: 9451573
DOI: 10.1007/BF03356568 -
Simulation in Healthcare : Journal of... Apr 2014The use of a stethoscope is essential to the delivery of continuous, supportive en route care during aeromedical evacuations. We compared the capability of 2... (Clinical Trial)
Clinical Trial Comparative Study
INTRODUCTION
The use of a stethoscope is essential to the delivery of continuous, supportive en route care during aeromedical evacuations. We compared the capability of 2 stethoscopes (electronic, Litmann 3000; conventional, Litmann Cardiology III) at detecting pathologic heart and lung sounds, aboard a C135, a medical transport aircraft.
METHODS
Sounds were mimicked using a mannequin-based simulator SimMan. Five practitioners examined the mannequin during a fly, with a variety of abnormalities as follows: crackles, wheezing, right and left lung silence, as well as systolic, diastolic, and Austin-Flint murmur. The comparison for diagnosis assessed (correct or wrong) between using the electronic and conventional stethoscopes were performed as a McNemar test.
RESULTS
A total of 70 evaluations were performed. For cardiac sounds, diagnosis was right in 0/15 and 4/15 auscultations, respectively, with conventional and electronic stethoscopes (McNemar test, P = 0.13). For lung sounds, right diagnosis was found with conventional stethoscope in 10/20 auscultations versus 18/20 with electronic stethoscope (P = 0.013).
CONCLUSIONS
Flight practitioners involved in aeromedical evacuation on C135 plane are more able to practice lung auscultation on a mannequin with this amplified stethoscope than with the traditional one. No benefit was found for heart sounds.
Topics: Adult; Air Ambulances; Auscultation; Computer Simulation; Female; Heart; Humans; Lung; Male; Manikins; Middle Aged; Noise, Transportation; Stethoscopes; Vibration
PubMed: 24695079
DOI: 10.1097/SIH.0b013e3182a833e0