Kocharian Armen, Sepehri Amir-Ahmad, Janani Azin, Malakan-Rad Elaheh
Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran ; Children's Medical Center, Pediatrics center of Excellence, Tehran, Iran.
CAPIS Biomedical Research Department, Mons, Belgium.
Iran J Pediatr. 2013 Aug;23(4):445-50.
Intelligent electronic stethoscopes and computer-aided auscultation systems have highlighted a new era in cardiac auscultation in children. Several collaborative multidisciplinary researches in this field are performed by physicians and computer specialists. Recently, a novel medical software device, Automated Auscultation Diagnosis Device (AADD), has been reported with intelligent diagnosing ability to differentiate cardiac murmur from breath sounds in children with normal and abnormal hearts due to congenital heart disease. The aim of this study is to determine efficiency, sensitivity and specificity of the diagnoses made by this AADD in children with and without cardiac disease.
We performed a cross-sectional study to determine efficiency, sensitivity and specificity of diagnoses made by AADD. Our patient population was two groups of children with and without cardiac disease(563 patients and 50 normal). SPSS version 16 was used to calculate sensitivity, specificity and efficiency and descriptive analysis.
Using cardiac sound recording in four conventional cardiac areas of auscultation (including aortic, pulmonary, tricuspid and mitral), AADD proved to have a ≥90% sensitivity, specificity and efficiency for making the correct diagnosis in children with heart disease and 100% diagnostic accuracy in children with normal hearts either with or without innocent murmurs.
Considering the high sensitivity, specificity and efficiency of AADD for making the correct diagnosis, application of this software is recommended for family physicians to enhance proper and timely patients' referral to pediatric cardiologists in order to provide better diagnostic facilities for pediatric patients who live in deprived and underserved rural areas with lack access to pediatric cardiologists.
智能电子听诊器和计算机辅助听诊系统开启了儿童心脏听诊的新时代。该领域有多项由医生和计算机专家开展的多学科合作研究。最近,一款新型医疗软件设备——自动听诊诊断设备(AADD)被报道具有智能诊断能力,可区分先天性心脏病导致的正常和异常心脏儿童的心脏杂音与呼吸音。本研究的目的是确定该AADD对患有和未患有心脏病儿童进行诊断的效率、敏感性和特异性。
我们进行了一项横断面研究,以确定AADD诊断的效率、敏感性和特异性。我们的患者群体为两组患有和未患有心脏病的儿童(563例患者和50例正常儿童)。使用SPSS 16版软件计算敏感性、特异性和效率,并进行描述性分析。
通过在四个传统心脏听诊区域(包括主动脉、肺动脉、三尖瓣和二尖瓣)记录心音,AADD在诊断患有心脏病的儿童时,其敏感性、特异性和效率均≥90%,在诊断心脏正常的儿童(无论有无无害杂音)时诊断准确率为100%。
鉴于AADD在做出正确诊断方面具有较高的敏感性、特异性和效率,建议家庭医生应用该软件,以便更妥善、及时地将患者转诊至儿科心脏病专家处,从而为生活在缺乏儿科心脏病专家的贫困和医疗服务不足农村地区的儿科患者提供更好的诊断设施。