@Article{info:doi/10.2196/23109,
author="Hirosawa, Takanobu
and Harada, Yukinori
and Ikenoya, Kohei
and Kakimoto, Shintaro
and Aizawa, Yuki
and Shimizu, Taro",
title="The Utility of Real-Time Remote Auscultation Using a Bluetooth-Connected Electronic Stethoscope: Open-Label Randomized Controlled Pilot Trial",
journal="JMIR Mhealth Uhealth",
year="2021",
month="Jul",
day="27",
volume="9",
number="7",
pages="e23109",
keywords="telemedicine; electronic stethoscope; simulator; remote auscultation; lung auscultation; cardiac auscultation; physical examination",
abstract="Background: The 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. Objective: This 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. Methods: This 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. Results: In 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. Conclusions: The 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 Registration: UMIN-CTR UMIN000040828; https://tinyurl.com/r24j2p6s and UMIN-CTR UMIN000041601; https://tinyurl.com/bsax3j5f ",
issn="2291-5222",
doi="10.2196/23109",
url="https://mhealth.jmir.org/2021/7/e23109",
url="https://doi.org/10.2196/23109",
url="http://www.ncbi.nlm.nih.gov/pubmed/34313598"
}