Evaluation of Internet-Connected Real-Time Remote Auscultation: An Open-Label Randomized Controlled Pilot Trial
Abstract
:1. Introduction
2. Materials and Methods
2.1. Study Design, Setting, and Participants
2.2. Procedures
2.2.1. Study Flow and Randomization
2.2.2. Training Session
2.2.3. Test Session
2.2.4. Simulator
2.2.5. Real-Time Remote Auscultation
2.3. Data Collection and Outcome Measures
2.4. Statistical Analysis
3. Results
3.1. Participants’ Profiles
3.2. Diagnostic Performance
3.2.1. Diagnostic Performance for Lung Sounds
3.2.2. Diagnostic Performance for Cardiac Sounds
4. Discussion
4.1. Principal Results
4.2. Strengths
4.3. Limitations
4.4. Comparions with Our Prior Work
4.5. Other Remote Auscultation Systems
5. Conclusions
Supplementary Materials
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Acknowledgments
Conflicts of Interest
References
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Variable | Remote Auscultation (N = 10) | Classical Auscultation (N = 10) | p Value |
---|---|---|---|
Age (years), mean ± SD | 31.6 ± 4 | 32.6 ± 5.1 | 0.63 1 |
No. of men, n (%) | 9 (90) | 6 (60) | 0.15 2 |
Years after graduation (years), mean ± (SD) | 6.8 ± 4 | 8.1 ± 5.5 | 0.54 1 |
Variable | Remote Auscultation (N = 10) | Classical Auscultation (N = 10) | p Value 1 |
---|---|---|---|
Total scores for correctly identified normal or abnormal cardiopulmonary sounds | 97/100 (97) | 98/100 (98) | >0.99 |
Total lung sounds, n (%) | 43/50 (86) | 45/50 (90) | 0.54 |
Normal | 10/10 (100) | 10/10 (100) | >0.99 |
Wheeze | 10/10 (100) | 9/10 (90) | 0.99 |
Rhonchi | 9/10 (90) | 9/10 (90) | >0.99 |
Coarse crackles | 8/10 (80) | 9/10 (90) | 0.54 |
Fine crackles | 6/10 (60) | 8/10 (80) | 0.34 |
Total cardiac sounds, n (%) | 36/50 (72) | 47/50 (94) | <0.05 |
Normal | 9/10 (90) | 10/10 (100) | 0.99 |
S3 gallop | 8/10 (80) | 10/10 (100) | 0.99 |
Aortic stenosis | 5/10 (50) | 9/10 (90) | 0.07 |
Aortic regurgitation | 7/10 (70) | 9/10 (90) | 0.28 |
Mitral regurgitation | 7/10 (70) | 9/10 (90) | 0.28 |
Participants’ Responses in the Remote Auscultation Group | |||||
Normal | Wheeze | Rhonchi | Coarse Crackles | Fine Crackles | |
Correct Answer | |||||
Normal | 10/10 | 0 | 0 | 0 | 0 |
Wheeze | 0 | 10/10 | 0 | 0 | 0 |
Rhonchi | 0 | 0 | 9/10 | 0 | 1/10 |
Coarse crackles | 0 | 0 | 0 | 8/10 | 2/10 |
Fine crackles | 0 | 0 | 1/10 | 3/10 | 6/10 |
Participants’ Responses in the Classical Auscultation Group | |||||
Normal | Wheeze | Rhonchi | Coarse Crackles | Fine Crackles | |
Correct Answer | |||||
Normal | 10/10 | 0 | 0 | 0 | 0 |
Wheezes | 0 | 9/10 | 1/10 | 0 | 0 |
Rhonchi | 0 | 1/10 | 9/10 | 0 | 0 |
Coarse crackles | 0 | 0 | 0 | 9/10 | 1/10 |
Fine crackles | 1/10 | 0 | 0 | 1/10 | 8/10 |
Participants’ Responses in the Remote Auscultation Group | |||||
Normal | S3 gallop | Aortic stenosis | Aortic regurgitation | Mitral Regurgitation | |
Correct Answer | |||||
Normal | 9/10 | 1/10 | 0 | 0 | 0 |
S3 gallop | 2/10 | 8/10 | 0 | 0 | 0 |
Aortic stenosis | 0 | 0 | 5/10 | 3/10 | 2/10 |
Aortic regurgitation | 0 | 1/10 | 2/10 | 7/10 | 0 |
Mitral regurgitation | 0 | 0 | 3/10 | 0 | 7/10 |
Participants’ Responses in the Classical Auscultation Group | |||||
Normal | S3 Gallop | Aortic Stenosis | Aortic Regurgitation | Mitral Regurgitation | |
Correct Answer | |||||
Normal | 10/10 | 0 | 0 | 0 | 0 |
S3 gallop | 0 | 10/10 | 0 | 0 | 0 |
Aortic stenosis | 0 | 0 | 9/10 | 1/10 | 0 |
Aortic regurgitation | 0 | 0 | 1/10 | 9/10 | 0 |
Mitral regurgitation | 0 | 0 | 1/10 | 0 | 9/10 |
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Ito, T.; Hirosawa, T.; Harada, Y.; Kakimoto, S.; Shimizu, T. Evaluation of Internet-Connected Real-Time Remote Auscultation: An Open-Label Randomized Controlled Pilot Trial. J. Pers. Med. 2022, 12, 1950. https://doi.org/10.3390/jpm12121950
Ito T, Hirosawa T, Harada Y, Kakimoto S, Shimizu T. Evaluation of Internet-Connected Real-Time Remote Auscultation: An Open-Label Randomized Controlled Pilot Trial. Journal of Personalized Medicine. 2022; 12(12):1950. https://doi.org/10.3390/jpm12121950
Chicago/Turabian StyleIto, Takahiro, Takanobu Hirosawa, Yukinori Harada, Shintaro Kakimoto, and Taro Shimizu. 2022. "Evaluation of Internet-Connected Real-Time Remote Auscultation: An Open-Label Randomized Controlled Pilot Trial" Journal of Personalized Medicine 12, no. 12: 1950. https://doi.org/10.3390/jpm12121950