JMIR Publications

ABSTRACT

Background:

The urgent need for telemedicine has become clear situation in the pandemic of the coronavirus disease 2019. 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 a lung simulator.

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. All participants attended a tutorial session, in which they listened to 15 lung sounds on the lung 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 ten lung sounds. The intervention group listened to the lung sounds remotely, using the electronic stethoscope, a Bluetooth transmitter, and a wireless, noise-canceling, stereo headset. The control group listened to the lung 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 lung sound. The two groups were compared using the Fisher exact test.

Results:

In total, 20 participants were included; eleven and nine were assigned to the intervention and control groups, respectively. There was no difference in age (P=.25), sex (P=.82), and years from graduation (P=.15) between the two groups. The overall test score 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%,).

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. Clinical Trial: UMIN-CTR UMIN000040828; https://upload.umin.ac.jp/cgi-open-bin/ctr_e/ctr_view.cgi?recptno=R000046222.