使用联网电子听诊器进行实时远程心脏听诊时心音图的效用：开放标签随机对照试验。

The utility of phonocardiograms in real-time remote cardiac auscultation using an internet-connected electronic stethoscope: Open-label randomized controlled pilot trial.

作者信息

Hirosawa Takanobu, Ito Takahiro, Harada Yukinori, Ikenoya Kohei, Yokose Masashi, Shimizu Taro

机构信息

Department of Diagnostic and Generalist Medicine, Dokkyo Medical University, Tochigi, Japan.

Satsuki Home Clinic Mashiko, Tochigi, Japan.

出版信息

Digit Health. 2023 Mar 5;9:20552076231161945. doi: 10.1177/20552076231161945. eCollection 2023 Jan-Dec.

DOI:10.1177/20552076231161945

PMID:36896331

原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9989428/

Abstract

BACKGROUND

We have shown classical cardiac auscultation was superior to remote auscultation. We developed a phonocardiogram system to visualize sounds in remote auscultation.

OBJECTIVE

This study aimed to evaluate the effect of phonocardiograms on the diagnostic accuracy in remote auscultation using a cardiology patient simulator.

METHODS

In this open-label randomized controlled pilot trial, we randomly assigned physicians to the real-time remote auscultation group (control group) or the real-time remote auscultation with the phonocardiogram group (intervention group). Participants attended a training session in which they auscultated 15 sounds with the correct classification. After that, participants attended a test session where they had to classify 10 sounds. The control group auscultated the sounds remotely using an electronic stethoscope, an online medical program and a 4-K TV speaker without watching the TV screen. The intervention group performed auscultation like the control group but watched the phonocardiogram on the TV screen. The primary and secondary outcomes were the total test scores and each sound score, respectively.

RESULTS

A total of 24 participants were included. The total test score in the intervention group (80/120, 66.7%) was higher than that in the control group (66/120, 55.0%), although the difference was statistically insignificant ( = .06). The correct answer rates of each sound were not different. Valvular/irregular rhythm sounds were not misclassified as normal sounds in the intervention group.

CONCLUSIONS

Using a phonocardiogram improved the total correct answer rate by more than 10% in remote auscultation, although statistically insignificant. The phonocardiogram could help physicians screen valvular/irregular rhythm sounds from normal sounds.

TRIAL REGISTRATION

UMIN-CTR UMIN000045271; https://upload.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000051710.

摘要

背景

我们已经表明传统心脏听诊优于远程听诊。我们开发了一种心音图系统，以可视化远程听诊中的声音。

目的

本研究旨在使用心脏病患者模拟器评估心音图对远程听诊诊断准确性的影响。

方法

在这项开放标签随机对照试验中，我们将医生随机分配到实时远程听诊组（对照组）或实时远程听诊加心音图组（干预组）。参与者参加了一次培训课程，在课程中他们听诊了15种声音并进行了正确分类。之后，参与者参加了一次测试课程，在该课程中他们必须对10种声音进行分类。对照组使用电子听诊器、在线医疗程序和4K电视扬声器远程听诊声音，不看电视屏幕。干预组的听诊方式与对照组相同，但在电视屏幕上观看心音图。主要和次要结局分别是总测试分数和每种声音的分数。