Dataset Information

Cardiac Auscultation Using Smartphones: Pilot Study.

ABSTRACT: Cardiac auscultation is a cost-effective, noninvasive screening tool that can provide information about cardiovascular hemodynamics and disease. However, with advances in imaging and laboratory tests, the importance of cardiac auscultation is less appreciated in clinical practice. The widespread use of smartphones provides opportunities for nonmedical expert users to perform self-examination before hospital visits.The objective of our study was to assess the feasibility of cardiac auscultation using smartphones with no add-on devices for use at the prehospital stage.We performed a pilot study of patients with normal and pathologic heart sounds. Heart sounds were recorded on the skin of the chest wall using 3 smartphones: the Samsung Galaxy S5 and Galaxy S6, and the LG G3. Recorded heart sounds were processed and classified by a diagnostic algorithm using convolutional neural networks. We assessed diagnostic accuracy, as well as sensitivity, specificity, and predictive values.A total of 46 participants underwent heart sound recording. After audio file processing, 30 of 46 (65%) heart sounds were proven interpretable. Atrial fibrillation and diastolic murmur were significantly associated with failure to acquire interpretable heart sounds. The diagnostic algorithm classified the heart sounds into the correct category with high accuracy: Galaxy S5, 90% (95% CI 73%-98%); Galaxy S6, 87% (95% CI 69%-96%); and LG G3, 90% (95% CI 73%-98%). Sensitivity, specificity, positive predictive value, and negative predictive value were also acceptable for the 3 devices.Cardiac auscultation using smartphones was feasible. Discrimination using convolutional neural networks yielded high diagnostic accuracy. However, using the built-in microphones alone, the acquisition of reproducible and interpretable heart sounds was still a major challenge.ClinicalTrials.gov NCT03273803; https://clinicaltrials.gov/ct2/show/NCT03273803 (Archived by WebCite at http://www.webcitation.org/6x6g1fHIu).

SUBMITTER: Kang SH

PROVIDER: S-EPMC5853766 | biostudies-literature | 2018 Feb

REPOSITORIES: biostudies-literature

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Cardiac Auscultation Using Smartphones: Pilot Study.

Kang Si-Hyuck SH Joe Byunggill B Yoon Yeonyee Y Cho Goo-Yeong GY Shin Insik I Suh Jung-Won JW

JMIR mHealth and uHealth 20180228 2

<h4>Background</h4>Cardiac auscultation is a cost-effective, noninvasive screening tool that can provide information about cardiovascular hemodynamics and disease. However, with advances in imaging and laboratory tests, the importance of cardiac auscultation is less appreciated in clinical practice. The widespread use of smartphones provides opportunities for nonmedical expert users to perform self-examination before hospital visits.<h4>Objective</h4>The objective of our study was to assess the ...[more]

PMID: 29490899

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Project description:BackgroundCardiac auscultation remains an efficient and accessible diagnostic tool, especially in resource-limited countries where modern diagnostic devices like cardiac ultrasound are expensive and difficult to access. However, cardiac auscultation skills of medical students and physicians are declining, mainly because of an ineffective teaching method for this technique. The objective of this study is to evaluate the effect of a digitally enhanced cardiac auscultation learning method on participants' theoretical knowledge and auscultation skills.MethodsThis will be a controlled study with two parallel arms (1:1). Participants (fourth-year medical students) will be divided into two groups: an intervention group (receiving additional lectures, clinical internship and audio listening sessions) and a control group (receiving additional lectures and clinical internship). At the beginning of the study, all participants will undergo a pre-test that consist of two parts: a knowledge assessment based on multiple-choice questions and a skills assessment based on recognition of cardiac sounds from audio files. Thereafter, three specific additional lectures on cardiac auscultation will be delivered and all participants will take part in their official clinical internship. During these clinical internships (eight weeks), participants of the intervention group will be invited to two listening sessions based on five digital recordings of heart sounds. At the end of the clinical internship, all participants will be invited to a post-test to evaluate their knowledge, skills and satisfaction according to their learning method. The main outcome will be the participants' knowledge progression. The other outcomes will be the participants' skills progression, participants' total progression and satisfaction. Data will be collected and analyzed in per protocol.DiscussionThis study could contribute to the development of a learning method that takes into account the advantages of the conventional method and the contribution of digital technology. Positive results could lead to improved cardiac auscultation skills among health professionals, especially in developing countries.Trial registrationThe trial is registered on the Pan-African Clinical Trials Registry ( http://www.pactr.org ) under unique identification number: PACTR202001504666847 , registered the 29 November 2019.

Project description:BackgroundThe urgent need for telemedicine has become clear in the COVID-19 pandemic. To facilitate telemedicine, the development and improvement of remote examination systems are required. A system combining an electronic stethoscope and Bluetooth connectivity is a promising option for remote auscultation in clinics and hospitals. However, the utility of such systems remains unknown.ObjectiveThis study was conducted to assess the utility of real-time auscultation using a Bluetooth-connected electronic stethoscope compared to that of classical auscultation, using lung and cardiology patient simulators.MethodsThis was an open-label, randomized controlled trial including senior residents and faculty in the department of general internal medicine of a university hospital. The only exclusion criterion was a refusal to participate. This study consisted of 2 parts: lung auscultation and cardiac auscultation. Each part contained a tutorial session and a test session. All participants attended a tutorial session, in which they listened to 15 sounds on the simulator using a classic stethoscope and were told the correct classification. Thereafter, participants were randomly assigned to either the real-time remote auscultation group (intervention group) or the classical auscultation group (control group) for test sessions. In the test sessions, participants had to classify a series of 10 lung sounds and 10 cardiac sounds, depending on the study part. The intervention group listened to the sounds remotely using the electronic stethoscope, a Bluetooth transmitter, and a wireless, noise-canceling, stereo headset. The control group listened to the sounds directly using a traditional stethoscope. The primary outcome was the test score, and the secondary outcomes were the rates of correct answers for each sound.ResultsIn total, 20 participants were included. There were no differences in age, sex, and years from graduation between the 2 groups in each part. The overall test score of lung auscultation in the intervention group (80/110, 72.7%) was not different from that in the control group (71/90, 78.9%; P=.32). The only lung sound for which the correct answer rate differed between groups was that of pleural friction rubs (P=.03); it was lower in the intervention group (3/11, 27%) than in the control group (7/9, 78%). The overall test score for cardiac auscultation in the intervention group (50/60, 83.3%) was not different from that in the control group (119/140, 85.0%; P=.77). There was no cardiac sound for which the correct answer rate differed between groups.ConclusionsThe utility of a real-time remote auscultation system using a Bluetooth-connected electronic stethoscope was comparable to that of direct auscultation using a classic stethoscope, except for classification of pleural friction rubs. This means that most of the real world's essential cardiopulmonary sounds could be classified by a real-time remote auscultation system using a Bluetooth-connected electronic stethoscope.Trial registrationUMIN-CTR UMIN000040828; https://tinyurl.com/r24j2p6s and UMIN-CTR UMIN000041601; https://tinyurl.com/bsax3j5f.

Project description:OBJECTIVES: The current review examines the effectiveness of simulation-based medical education (SBME) for training health professionals in cardiac physical examination and examines the relative effectiveness of key instructional design features. METHODS: Data sources included a comprehensive, systematic search of MEDLINE, EMBASE, CINAHL, PsychINFO, ERIC, Web of Science, and Scopus through May 2011. Included studies investigated SBME to teach health profession learners cardiac physical examination skills using outcomes of knowledge or skill. We carried out duplicate assessment of study quality and data abstraction and pooled effect sizes using random effects. RESULTS: We identified 18 articles for inclusion. Thirteen compared SBME to no-intervention (either single group pre-post comparisons or SBME added to other instruction common to all learners, such as traditional bedside teaching), three compared SBME to other educational interventions, and two compared two SBME interventions. Meta-analysis of the 13 no-intervention comparison studies demonstrated that simulation-based instruction in cardiac auscultation was effective, with pooled effect sizes of 1.10 (95 % CI 0.49-1.72; p?<?0.001; I(2)?=?92.4 %) for knowledge outcomes and 0.87 (95 % CI 0.52-1.22; p?<?0.001; I(2) = 91.5 %) for skills. In sub-group analysis, hands-on practice with the simulator appeared to be an important teaching technique. Narrative review of the comparative effectiveness studies suggests that SBME may be of similar effectiveness to other active educational interventions, but more studies are required. LIMITATIONS: The quantity of published evidence and the relative lack of comparative effectiveness studies limit this review. CONCLUSIONS: SBME is an effective educational strategy for teaching cardiac auscultation. Future studies should focus on comparing key instructional design features and establishing SBME's relative effectiveness compared to other educational interventions.

Dataset Information

Cardiac Auscultation Using Smartphones: Pilot Study.

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Cardiac Auscultation Using Smartphones: Pilot Study.

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