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Heart murmurs recorded by a sensor based electronic stethoscope and e-mailed for remote assessment

机译:通过基于传感器的电子听诊器记录心脏杂音并通过电子邮件发送以进行远程评估

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>Background: Heart murmurs are common in children, and they are often referred to a specialist for examination. A clinically innocent murmur does not need further investigation. The referral area of the University Hospital is large and sparsely populated. A new service for remote auscultation (telemedicine) of heart murmurs in children was established where heart sounds and short texts were sent as an attachment to e-mails. >Aim: To assess the clinical quality of this method. >Methods: Heart sounds from 47 patients with no murmur (n = 7), with innocent murmurs (n = 20), or with pathological murmurs (n = 20) were recorded using a sensor based stethoscope and e-mailed to a remote computer. The sounds were repeated, giving 100 cases that were randomly distributed on a compact disc. Four cardiologists assessed and categorised the cases as having "no murmur", "innocent murmur", or "pathological murmur", recorded the assessment time per case, their degree of certainty, and whether they recommended referral. >Results: On average, 2.1 minutes were spent on each case. The mean sensitivity and specificity were 89.7% and 98.2% respectively, and the inter-observer and intra-observer variabilities were low (kappa 0.81 and 0.87), respectively. A total of 93.4% of cases with a pathological murmur and 12.6% of cases with an innocent murmur were recommended for referral. >Conclusion: Telemedical referral of patients with heart murmurs for remote assessment by a cardiologist is safe and saves time. Skilled auscultation is adequate to detect patients with innocent murmurs.
机译:>背景:心脏杂音在儿童中很常见,通常会转介给专家进行检查。临床上无辜杂音无需进一步检查。大学医院的转诊面积很大,人烟稀少。建立了一项针对儿童心脏杂音的远程听诊(远程医疗)的新服务,通过该服务将心音和短文本作为电子邮件的附件发送。 >目标:评估此方法的临床质量。 >方法:使用基于传感器的听诊器和e记录了47名无杂音(n = 7),无辜杂音(n = 20)或病理性杂音(n = 20)的患者的心音。邮寄到远程计算机。重复声音,得到100个案件,这些案件随机分布在光盘上。四名心脏病专家对这些病例进行了评估并归类为“无杂音”,“无辜杂音”或“病理性杂音”,记录了每例的评估时间,确定程度以及是否建议转诊。 >结果:每个案例平均花费2.1分钟。平均敏感性和特异性分别为89.7%和98.2%,观察者间和观察者内变异性较低(κ分别为0.81和0.87)。建议将93.4%的病理性杂音病例和12.6%的无辜杂音病例转诊。 >结论:由心脏病专家对患有心脏杂音的患者进行远程医疗转诊是安全的,而且可以节省时间。熟练的听诊足以检测无辜杂音的患者。

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