Pulmonary Auscultation using Mobile Devices - Feasibility Study in Respiratory Diseases

Abstract

Conventional lung auscultation is essential in the management of respiratory diseases. However, detecting adventitious sounds outside medical facilities remains challenging. We assessed the feasibility of lung auscultation using the smartphone's embedded microphone in real-world clinical practice. Ninety-five patients (median[interquartile range] 16[11-24]y; 52% female; 42 cystic fibrosis, 24 asthma, 17 other respiratory diseases and 12 no respiratory diseases) were re-cruited at Pediatrics and Pulmonology departments of a tertiary hospital. Clinicians performed conventional auscultation at 4 locations (trachea, right anterior chest, right and left lung bases), documenting any adventitious sounds. Smartphone auscultation was recorded in the same loca-tions. The recordings (n=738) were classified by two annotators and agreement calculated (%; Cohen's k(95%CI)). Recordings with quality were obtained in 88% of the participants and 69% of the recordings (91%; k=0.80(95%CI 0.75-0.85)), with the quality proportion being higher at the trachea (79%) and lower in the asthma group (52%). Adventitious sounds were present in only 27% of the participants and 12% of the recordings (91%; k=0.57(95%CI 0.46-0.68)), which may have contributed to the fair agreement between conventional and smartphone auscultation (86%; k=0.25(95%CI 0.13-0.37)). Our results show that smartphone auscultation was feasible, but further investigation is required to improve its agreement with conventional auscultation.