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A Comparison of Electronic and Traditional Stethoscopes in the Heart Auscultation of Obese Patients

机译：肥胖患者心脏听诊中电子听诊器与传统听诊器的比较

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Background and objectives: As the prevalence of obesity is increasing in a population, diagnostics becomes more problematic. Our aim was to compare the 3M Littmann 3200 Electronic Stethoscope and 3M Littman Cardiology III Mechanical Stethoscope in the auscultation of obese patients. Methods. A total of 30 patients with body mass index >30 kg/m2 were auscultated by a cardiologist and a resident physician: 15 patients by one cardiologist and one resident and 15 patients by another cardiologist and resident using both stethoscopes. In total, 960 auscultation data points were verified by an echocardiogram. Sensitivity and specificity data were calculated. Results. Sensitivity for regurgitation with valves combined was higher when the electronic stethoscope was used by the cardiologist (60.0% vs. 40.9%, p = 0.0002) and the resident physician (62.1% vs. 51.5%, p = 0.016); this was also the same when stenoses were added (59.4% vs. 40.6%, p = 0.0002, and 60.9% vs. 50.7%, p = 0.016, respectively). For any lesion, there were no significant differences in specificity between the electronic and acoustic stethoscopes for the cardiologist (92.4% vs. 94.2%) and the resident physician (93.6% vs. 94.7%). The detailed analysis by valve showed one significant difference in regurgitation at the mitral valve for the cardiologist (80.0% vs. 56.0%, p = 0.031). No significant difference in specificity between the stethoscopes was found when all lesions, valves and both physicians were combined (93.0% vs. 94.4%, p = 0.30), but the electronic stethoscope had higher sensitivity than the acoustic (60.1% vs. 45.7%, p < 0.0001). The analysis when severity of the abnormality was considered confirmed these results. Conclusions. There is an indication of increased sensitivity using the electronic stethoscope. Specificity was high using the electronic and acoustic stethoscope.
机译：背景和目标：随着肥胖症在人群中的流行程度增加，诊断变得更加棘手。我们的目的是比较3M Littmann 3200电子听诊器和3M Littman Cardiology III机械听诊器在肥胖患者的听诊中的作用。方法。心脏病专家和住院医师共听诊了30名体重指数> 30 kg / m 2 的患者：一名心脏病专家和一名住院医师15例，另一心脏病专家和住院医师同时使用这两种方法听诊器。通过超声心动图检查总共验证了960个听诊数据点。计算敏感性和特异性数据。结果。当心脏科医师使用电子听诊器和住院医师使用电子听诊器时，结合瓣膜返流的敏感性较高（60.0％vs. 40.9％，p = 0.0002）（62.1％vs. 51.5％，p = 0.016）；添加狭窄剂时也是如此（分别为59.4％对40.6％，p = 0.0002，和60.9％对50.7％，p = 0.016）。对于任何病变，心脏病专家的电子听诊器和声学听诊器（92.4％对94.2％）与住院医师（93.6％对94.7％）的特异性没有显着差异。对于心脏科医师，通过瓣膜进行的详细分析显示二尖瓣返流存在显着差异（80.0％对56.0％，p = 0.031）。当所有病灶，瓣膜和两位医生合并使用时，听诊器之间的特异性没有显着差异（93.0％vs. 94.4％，p = 0.30），但是电子听诊器的灵敏度高于声学听诊器（60.1％vs. 45.7％）。 ，p <0.0001）。当考虑异常严重性时的分析证实了这些结果。结论。有迹象表明，使用电子听诊器会提高灵敏度。使用电子和声学听诊器的特异性很高。

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