Pinto C, Pereira D, Ferreira-Coimbra J, Portugues J, Gama V, Coimbra M
Annu Int Conf IEEE Eng Med Biol Soc. 2017 Jul;2017:2610-2613. doi: 10.1109/EMBC.2017.8037392.
There are several electronic stethoscopes available on the market today, with a very high potential for healthcare namely telemedicine, assisted decision and education. However, there are no recent comparatives studies published about the recording quality of auscultation sounds. In this study we aim to: a) define a ranking, according to experts opinion of 6 of the most relevant electronic stethoscopes on the market today; b) verify if there are any relations between a stethoscope's performance and the type of pathology present; c) analyze if some pathologies are more easily identified than others when using electronic auscultation. Our methodology consisted in creating two study groups: the first group included 18 cardiologists and cardiology house officers, acting as the gold standard of this work. The second included 30 medical students. Using a database of heart sounds recorded in real hospital environments, we applied questionnaires to observers from each group. The first group listened to 60 cardiac auscultations recorded by the 6 stethoscopes, and each one was asked to identify the pathological sound present: aortic stenosis, mitral regurgitation or normal. The second group was asked to choose, between two auscultation recordings, using as criteria the best sound quality for the identification of pathological sounds. Results include a total of 1080 evaluations, in which 72% of cases were correctly diagnosed. A detailed breakdown of these results is presented in this paper. As conclusions, results showed that the impact of the differences between stethoscopes is very small, given that we did not find statistically significant differences between all pairs of stethoscopes. Normal sounds showed to be easier to identify than pathological sounds, but we did not find differences between stethoscopes in this identification.
如今市场上有几种电子听诊器，在远程医疗、辅助决策和教育等医疗保健领域具有很高的潜力。然而，目前尚无关于听诊声音记录质量的近期比较研究发表。在本研究中，我们旨在：a）根据专家意见，对当今市场上6种最相关的电子听诊器进行排名；b）验证听诊器的性能与所存在的病理类型之间是否存在任何关系；c）分析使用电子听诊时某些病理情况是否比其他情况更容易识别。我们的方法包括创建两个研究组：第一组包括18名心脏病专家和心脏病住院医生，作为这项工作的金标准。第二组包括30名医学生。我们使用在真实医院环境中记录的心音数据库，向每组观察者发放问卷。第一组听取了由6种听诊器记录的60次心脏听诊，要求每个人识别所存在的病理声音：主动脉瓣狭窄、二尖瓣反流或正常。第二组被要求在两次听诊记录之间进行选择，以识别病理声音的最佳音质为标准。结果包括总共1080次评估，其中72%的病例被正确诊断。本文给出了这些结果的详细分类。作为结论，结果表明听诊器之间差异的影响非常小，因为我们在所有听诊器对之间未发现统计学上的显著差异。正常声音显示比病理声音更容易识别，但我们在这种识别中未发现听诊器之间存在差异。
