Published online December 1, 2006
PEDIATRICS Vol. 118 No. 6 December 2006, pp. 2322-2325 (doi:10.1542/peds.2006-1557)
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me when eLetters are posted
Right arrow Alert me if a correction is posted
Right arrow Citation Map
Services
Right arrow E-mail this article to a friend
Right arrow Similar articles in this journal
Right arrow Similar articles in Web of Science
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Add to My File Cabinet
Right arrow Download to citation manager
Right arrowRequest Permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via CrossRef
Right arrow Citing Articles via Web of Science (7)
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by Finley, J. P.
Right arrow Articles by Amit, M.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by Finley, J. P.
Right arrow Articles by Amit, M.
Related Collections
Right arrow Heart & Blood Vessels
Social Bookmarking
Add to CiteULike   Add to Connotea   Add to Del.icio.us   Add to Digg   Add to Facebook   Add to Reddit   Add to Technorati   Add to Twitter  
What's this?

ARTICLE

Assessing Children’s Heart Sounds at a Distance With Digital Recordings

John P. Finley, MDa, Andrew E. Warren, MDa, Geoffrey P. Sharratt, MDa and Minoli Amit, MDb

a Children’s Heart Centre, Izaak Walton Killam Health Centre, Halifax, Nova Scotia, Canada
b Department of Pediatrics, Dalhousie University, Halifax, Nova Scotia, Canada

OBJECTIVE. The objective of this study was to assess whether computer-stored digital sound recordings can be used to distinguish innocent from pathologic systolic murmurs.

METHODS. Recordings of 55 children aged 1 month to 19 years were made remotely with the use of a digital stethoscope and were e-mailed to a computer in our center for later assessment. Eight-second recordings were made by a physician in 2 to 4 locations on the chest. Three cardiologists who were blinded to the diagnosis reviewed the recordings independently using stethophones to assess the splitting of the second heart sound and whether murmurs were innocent or pathologic. Diagnoses were confirmed with echocardiography.

RESULTS. Seventeen children had innocent murmurs and 38 had pathologic murmurs. For the 3 cardiologists, sensitivity was 0.87 to 1.0, specificity was 0.82 to 0.88, negative predictive value was 0.75 to 1.0, and positive predictive value was 0.93 to 0.95. Assessment of splitting of second heart sound was highly accurate.

CONCLUSIONS. Digital recordings of children’s heart sounds allow reliable differentiation between innocent and pathologic murmurs. Use of this technology may allow remote diagnosis of childhood murmurs and avoid the expense and stress of travel to pediatric cardiology centers for some children. Cardiologists who use recordings should assess their diagnostic accuracy before clinical application.

Key Words: pediatrics • murmurs • auscultation • stethoscope • telemedicine

Abbreviations: NPV—negative predictive value • PPV—positive predictive value

Accepted Aug 21, 2006.


Add to CiteULike CiteULike   Add to Connotea Connotea   Add to Del.icio.us Del.icio.us   Add to Digg Digg   Add to Facebook Facebook   Add to Reddit Reddit   Add to Technorati Technorati   Add to Twitter Twitter    What's this?


This article has been cited by other articles:


Home page
 CLIN PEDIATRHome page
J. P. Finley and A. E. Warren
Letter to the Editor
Clinical Pediatrics, September 1, 2009; 48(7): 789 - 789.
[PDF]

Home page
 Evid. Based Med.Home page
Other articles noted
Evid. Based Med., August 1, 2007; 12(4): 127 - 128.
[Full Text] [PDF]