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2018 ; 6
(2
): e49
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Cardiac Auscultation Using Smartphones: Pilot Study
#MMPMID29490899
Kang SH
; Joe B
; Yoon Y
; Cho GY
; Shin I
; Suh JW
JMIR Mhealth Uhealth
2018[Feb]; 6
(2
): e49
PMID29490899
show ga
BACKGROUND: Cardiac auscultation is a cost-effective, noninvasive screening tool
that can provide information about cardiovascular hemodynamics and disease.
However, with advances in imaging and laboratory tests, the importance of cardiac
auscultation is less appreciated in clinical practice. The widespread use of
smartphones provides opportunities for nonmedical expert users to perform
self-examination before hospital visits. OBJECTIVE: The objective of our study
was to assess the feasibility of cardiac auscultation using smartphones with no
add-on devices for use at the prehospital stage. METHODS: We performed a pilot
study of patients with normal and pathologic heart sounds. Heart sounds were
recorded on the skin of the chest wall using 3 smartphones: the Samsung Galaxy S5
and Galaxy S6, and the LG G3. Recorded heart sounds were processed and classified
by a diagnostic algorithm using convolutional neural networks. We assessed
diagnostic accuracy, as well as sensitivity, specificity, and predictive values.
RESULTS: A total of 46 participants underwent heart sound recording. After audio
file processing, 30 of 46 (65%) heart sounds were proven interpretable. Atrial
fibrillation and diastolic murmur were significantly associated with failure to
acquire interpretable heart sounds. The diagnostic algorithm classified the heart
sounds into the correct category with high accuracy: Galaxy S5, 90% (95% CI
73%-98%); Galaxy S6, 87% (95% CI 69%-96%); and LG G3, 90% (95% CI 73%-98%).
Sensitivity, specificity, positive predictive value, and negative predictive
value were also acceptable for the 3 devices. CONCLUSIONS: Cardiac auscultation
using smartphones was feasible. Discrimination using convolutional neural
networks yielded high diagnostic accuracy. However, using the built-in
microphones alone, the acquisition of reproducible and interpretable heart sounds
was still a major challenge. TRIAL REGISTRATION: ClinicalTrials.gov NCT03273803;
https://clinicaltrials.gov/ct2/show/NCT03273803 (Archived by WebCite at
http://www.webcitation.org/6x6g1fHIu).
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