Smartphone Pulmonary Auscultation in Paediatrics - feasibility and acceptance by end-users

Abstract

Stethoscope lung auscultation is a crucial part of the respiratory examination and diagnosis in various respiratory disorders and exacerbations. However, because it has well-known limitations, it has been shown that smartphone built-in microphone auscultation is a feasible alternative to the stethoscope, when applied by a physician. We aimed to assess this technology by real end-users. We recruited 36 children (69% male, mean[standard deviation] age 10.1[3.1]y; 44% asthma, 39% other respiratory diseases, 17% no respiratory diseases) at the Paediatrics department of a tertiary hospital. Firstly, physicians performed conventional auscultation with analog stethoscopes at 4 locations - trachea, right anterior chest, right and left lung bases - documenting any adventitious sounds. Afterwards, smartphone auscultation was recorded twice in those 4 locations, first by the physician (n=220) and later by the parent (n=264). The recordings (n=484) were classified by 3 annotators on quality and adventitious sounds. Most recordings had quality (80%physicians',72%parents'). Proportion of adventitious sounds (12% and 10%) and agreement with the stethoscope (81%; Cohen's K=0.193 and 80%; Cohen's K=0.118) were very similar in the physicians' and parents' recordings, respectively. Our results show that smartphone auscultation was feasible by an end-user, but further investigation is required to improve its agreement with conventional auscultation.