Source: Annual Congress 2002 - Asthma in primary care - Assessment and control
Disease area: Airway diseases

Abstract

The aim of our study was to compare the usefulness of acoustic and electronic stethoscope (e-steth™ – e-med innovation inc™, Texas, U.S.A. with Cardio-Mail™ software) in the management of asthmatic patients. Our hypothesis was that electronic stethoscope, which amplify and select respiratory sounds, could have higher sensitivity than the traditional stethoscope in detecting wheezing in asthmatic patients. Two medical doctors (MD1 and MD2) carried out patients' medical examination without knowing the result of the other MD, using both stethoscopes. Then, patients underwent spirometry; obstruction was defined as a FEV1/FVC [lte]88% for men and [lte] 89% for women. We enrolled 153 consecutive asthmatic outpatients: 41 (27%) had a bronchial obstruction. Both MD detected expiratory wheezing in 35 patients. Wheezing detected by the acoustic stethoscope was always confirmed by the electronic one, while MD1 and MD2 detected wheezing in 14 and 15 patients respectively only by the electronic stethoscope. The sensitivity, using bronchial obstruction as gold standard, of electronic stethoscope was significant higher than the acoustic one (74.4 vs 42.7%; p<0.01), while the specificity was >90% for both the instruments. Our preliminary data suggest that the electronic stethoscope is more sensitive that the acoustic one in detecting wheezing in asthmatic patients with bronchial obstruction.

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F. Di Marco, B. Boveri, E. Belloli, A. Pistone, M. Verga, L. Allegra, S. Centanni (Milan, Italy). Sensitivity of acoustic and electronic stethoscope in detecting bronchial obstruction in asthmatic patients. Eur Respir J 2002; 20: Suppl. 38, 598

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