Background Chest examination by auscultation is essential in patients with COVID-19, especially those with poor respiratory conditions, such as severe pneumonia and respiratory dysfunction, and intensive cases who are intubated and whose breathing is assisted with a ventilator. However, proper auscultation of these patients is difficult when medical workers wear personal protective equipment and when it is necessary to minimize contact with patients. Objective The objective of our study was to design and develop a low-cost electronic stethoscope enabling ear-contactless auscultation and digital storage of data for further analysis. The clinical feasibility of our device was assessed in comparison to a standard electronic stethoscope. Methods We developed a prototype of the ear-contactless electronic stethoscope, called Auscul Pi, powered by Raspberry Pi and Python. Our device enables real-time capture of auscultation sounds with a microspeaker instead of an earpiece, and it can store data files for later analysis. We assessed the feasibility of using this stethoscope by detecting abnormal heart and respiratory sounds from 8 patients with heart failure or structural heart diseases and from 2 healthy volunteers and by comparing the results with those from a 3M Littmann electronic stethoscope. Results We were able to conveniently operate Auscul Pi and precisely record the patients’ auscultation sounds. Auscul Pi showed similar real-time recording and playback performance to the Littmann stethoscope. The phonocardiograms of data obtained with the two stethoscopes were consistent and could be aligned with the cardiac cycles of the corresponding electrocardiograms. Pearson correlation analysis of amplitude data from the two types of phonocardiograms showed that Auscul Pi was correlated with the Littmann stethoscope with coefficients of 0.3245-0.5570 for healthy participants (P<.001) and of 0.3449-0.5138 among 4 patients (P<.001). Conclusions Auscul Pi can be used for auscultation in clinical practice by applying real-time ear-contactless playback followed by quantitative analysis. Auscul Pi may allow accurate auscultation when medical workers are wearing protective suits and have difficulties in examining patients with COVID-19. Trial Registration ChiCTR.org.cn ChiCTR2000033830; http://www.chictr.org.cn/showproj.aspx?proj=54971.
BACKGROUND In the battle against COVID-19, auscultation examination was essential, especially to patients with poor respiratory conditions, such as severe pneumonia, respiratory dysfunction, and intensive cases who were intubated and assisted with ventilators. However, auscultation was hard to be accomplished on the infected patients due to the safety concern and unavailability for medical workers wearing personal protective suits. OBJECTIVE The objective of our study was to design and develop an electronic stethoscope with the characteristics of ear-contactless auscultation, low-cost property, and digital storage for further analysis. An assessment of its clinical feasibility should also be made with the comparison to the electronic stethoscope currently in use. METHODS We developed a prototype of the electronic stethoscope without ear-contact, Auscul Pi, powered by Raspberry Pi and Python, which can make real-time auscultation sounds played with a micro-speaker instead of ear pieces, and it can also store data files for further analysis. We utilized this stethoscope to assess the feasibility by detecting abnormal heart and breath sounds from 8 patients by comparing it with 3M Littmann electronic stethoscope, and 2 healthy volunteers were included for controls. We then plotted the phonocardiography of heart sounds for visualization for the comparisons. RESULTS We were able to operate Auscul Pi conveniently and record the auscultation sounds precisely in practice from the aspects of ergonomics and information technology. A total of 10 participants were recruited to receive auscultation examination with Auscul Pi and 3M Littmann electronic stethoscope. In terms of the real-time playout and recorded audio of heart sounds and breath sounds, the Auscul Pi showed consistency to 3M Littmann. As for the heart sounds, we also plotted phonocardiograph based on the data generated by Auscul Pi and 3M Littmann, and aligned them with the cardiac cycle of ECG respectively. The phonocardiography showed good conformity between Auscul Pi and 3M Littmann according to the waveforms. CONCLUSIONS Auscul Pi is feasible to perform the auscultation in clinical practice by applying real-time ear-contactless playout and later quantified analysis of auscultation sounds. So, it is expected to benefit the patients with COVID-19 examined by medical employees wearing protective suits and having difficulties in auscultation. CLINICALTRIAL ChiCTR.org.cn ChiCTR2000033830; http://www.chictr.org.cn/showproj.aspx?proj=54971
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