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1.
Biomed Eng Online ; 21(1): 63, 2022 Sep 06.
Article in English | MEDLINE | ID: covidwho-2009406

ABSTRACT

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.


Subject(s)
COVID-19 , Stethoscopes , Auscultation/methods , COVID-19/diagnosis , Electronics , Heart Auscultation/methods , Heart Murmurs , Humans
2.
Hosp Pract (1995) ; 49(4): 240-244, 2021 Oct.
Article in English | MEDLINE | ID: covidwho-1284837

ABSTRACT

Rene Laennec came up with the idea of a stethoscope in 1816 to avoid the embarrassment of performing immediate auscultation on women. Soon many doctors around the world started using this tool because of its increased accuracy and ease of use. Stethoscopes hold great significance in the medical community. However, is the importance placed on stethoscopes justified today? We now have devices like portable ultrasound machines that make it much easier to visualize the body. These devices offset their higher initial cost by reducing downstream costs due to their greater accuracy and their capability of detecting diseases at an earlier stage. Also, because of the COVID-19 pandemic, new ways are being investigated to reduce the transmission of diseases. Stethoscopes being a possible vector for infectious agents coupled with the advent of newer devices that can visualize the body with greater accuracy put into question the continued use of stethoscopes today. With that said, the use of stethoscopes to diagnose diseases is still crucial in places where buying these new devices is not yet possible. The stethoscope is a great symbol of medicine, but its use needs to be in line with what is best for the patient.


Subject(s)
COVID-19/epidemiology , Stethoscopes/microbiology , Auscultation/methods , COVID-19/transmission , History, 19th Century , Humans , Pandemics , SARS-CoV-2 , Stethoscopes/history
3.
BMC Pulm Med ; 21(1): 103, 2021 Mar 24.
Article in English | MEDLINE | ID: covidwho-1150397

ABSTRACT

BACKGROUND: Lung auscultation is fundamental to the clinical diagnosis of respiratory disease. However, auscultation is a subjective practice and interpretations vary widely between users. The digitization of auscultation acquisition and interpretation is a particularly promising strategy for diagnosing and monitoring infectious diseases such as Coronavirus-19 disease (COVID-19) where automated analyses could help decentralise care and better inform decision-making in telemedicine. This protocol describes the standardised collection of lung auscultations in COVID-19 triage sites and a deep learning approach to diagnostic and prognostic modelling for future incorporation into an intelligent autonomous stethoscope benchmarked against human expert interpretation. METHODS: A total of 1000 consecutive, patients aged ≥ 16 years and meeting COVID-19 testing criteria will be recruited at screening sites and amongst inpatients of the internal medicine department at the Geneva University Hospitals, starting from October 2020. COVID-19 is diagnosed by RT-PCR on a nasopharyngeal swab and COVID-positive patients are followed up until outcome (i.e., discharge, hospitalisation, intubation and/or death). At inclusion, demographic and clinical data are collected, such as age, sex, medical history, and signs and symptoms of the current episode. Additionally, lung auscultation will be recorded with a digital stethoscope at 6 thoracic sites in each patient. A deep learning algorithm (DeepBreath) using a Convolutional Neural Network (CNN) and Support Vector Machine classifier will be trained on these audio recordings to derive an automated prediction of diagnostic (COVID positive vs negative) and risk stratification categories (mild to severe). The performance of this model will be compared to a human prediction baseline on a random subset of lung sounds, where blinded physicians are asked to classify the audios into the same categories. DISCUSSION: This approach has broad potential to standardise the evaluation of lung auscultation in COVID-19 at various levels of healthcare, especially in the context of decentralised triage and monitoring. TRIAL REGISTRATION: PB_2016-00500, SwissEthics. Registered on 6 April 2020.


Subject(s)
Auscultation/methods , COVID-19 Testing/methods , COVID-19/diagnosis , Deep Learning , Adolescent , Adult , Aged , Aged, 80 and over , Algorithms , Case-Control Studies , Clinical Decision Rules , Clinical Protocols , Female , Humans , Male , Middle Aged , Prognosis , Prospective Studies , Risk Assessment , Triage , Young Adult
4.
Int J Med Sci ; 18(6): 1415-1422, 2021.
Article in English | MEDLINE | ID: covidwho-1110663

ABSTRACT

Objective: SARS-CoV-2 (originally named COVID-2019) pneumonia is currently prevalent worldwide. The number of cases has increased rapidly but the auscultatory characteristics of affected patients and how to use it to predict who is most likely to survive or die are not available. This study aims to describe the auscultatory characteristics and its clinical relativity of SARS-CoV-2 pneumonia by using a wireless stethoscope. Material and methods: A cross-sectional, observational, single-center case series of 30 consecutive hospitalized patients with confirmed SARS-CoV-2 pneumonia at Leishenshan Hospital in Wuhan, China, were enrolled from March 9 to April 5, 2020. Clinical, laboratory, radiological, treatment data and lung auscultation were collected and analyzed. Lung auscultation was acquired by a wireless electronic stethoscope. Auscultatory characteristics of the moderate, severe, and critically ill patients were compared. Results: Kinds of crackles including fine crackles and wheezing were heard and recorded in these patients. Velcro crackles were heard in most critically ill patients (6/10). Besides, patients with Velcro crackles were all dead (6/6). There was no positive lung auscultatory finding in the moderate group and little positive lung auscultatory findings (4/10) in the severe group. Conclusion: Velcro crackles can be auscultated by this newly designed electronic wireless stethoscope in most critically ill patients infected by SARS-CoV-2 and predicts a poor prognosis. Moderate and severe patients without positive auscultatory findings may have a better prognosis.


Subject(s)
Auscultation/methods , Lung/diagnostic imaging , Pneumonia/diagnostic imaging , Pneumonia/virology , Wireless Technology , Aged , Case-Control Studies , China , Critical Illness , Cross-Sectional Studies , Female , Humans , Male , Middle Aged , SARS-CoV-2/pathogenicity , Stethoscopes
5.
J Acoust Soc Am ; 149(1): 66, 2021 01.
Article in English | MEDLINE | ID: covidwho-1035286

ABSTRACT

During the COVID-19 outbreak, the auscultation of heart and lung sounds has played an important role in the comprehensive diagnosis and real-time monitoring of confirmed cases. With clinicians wearing protective clothing in isolation wards, a potato chip tube stethoscope, which is a secure and flexible substitute for a conventional stethoscope, has been used by Chinese medical workers in the first-line treatment of COVID-19. In this study, an optimal design for this simple cylindrical stethoscope is proposed based on the fundamental theory of acoustic waveguides. Analyses of the cutoff frequency, sound power transmission coefficient, and sound wave propagation in the uniform lossless tube provide theoretical guidance for selecting the geometric parameters for this simple cylindrical stethoscope. A basic investigation into the auscultatory performances of the original tube and the optimal tube with proposed dimensions was conducted both in a semi-anechoic chamber and in a quiet laboratory. Both experimental results and front-line doctors' clinical feedback endorse the proposed theoretical optimization.


Subject(s)
Acoustics , Auscultation/standards , COVID-19/diagnosis , Equipment Design/standards , Stethoscopes/standards , Acoustics/instrumentation , Auscultation/instrumentation , Auscultation/methods , COVID-19/epidemiology , COVID-19/physiopathology , Equipment Design/instrumentation , Equipment Design/methods , Humans , Respiratory Sounds/physiology , Respiratory Sounds/physiopathology
6.
GMS J Med Educ ; 37(7): Doc102, 2020.
Article in English | MEDLINE | ID: covidwho-970665

ABSTRACT

Introduction: Auscultation skills are among the basic techniques to be learned in medical school. Such skills are achieved through supervised examination of patients often supported by simulator-based learning. The emergence of COVID-19 has disrupted and continues to hinder hands-on on-site medical training on a global scale. Project description: An effective virtual auscultation course was established in times of contact restrictions due to COVID-19 at the Medical Faculty of the Heinrich Heine University Düsseldorf. The interactive case-based webinar was designed to improve listening techniques, description and interpretation of auscultation findings in an off-site context. Clinical cases with pre-recorded auscultation sounds and additional case-based diagnostics were presented. The course focused on common heart murmurs including aortic and mitral valve stenosis and regurgitation as well as congenital heart defects (ventricular septal defect and patent ductus arteriosus). Results: The course was well received by the students and assessed as being useful and instructive. Assessment of learning effects, such as detection of pathological findings before and after training, is ongoing as part of a subsequent trial. Conclusion: Virtual interactive learning using a sound simulation lesson with clinical case presentations via video chat can well be used as a supplement to practical auscultation training. This learning format could also play a useful role in the curriculum of medical studies once contact restrictions are revoked.


Subject(s)
Auscultation/methods , COVID-19/epidemiology , Education, Distance/organization & administration , Education, Medical/organization & administration , Videoconferencing/organization & administration , Humans , Pandemics , SARS-CoV-2 , Students, Medical/psychology
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