Utility of Store-and-Forward Pediatric Telecardiology Evaluation in Distinguishing Normal From Pathologic Pediatric Heart Sounds
Because pediatric cardiologists can accurately diagnose innocent murmurs by physical exam alone, the authors developed a system for remote cardiac auscultation. They hypothesized that their system could accurately classify auscultatory findings as normal/innocent or pathologic. Patients undergoing e...
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| Veröffentlicht in: | Clinical pediatrics 2008-11, Vol.47 (9), p.919-925 |
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| container_title | Clinical pediatrics |
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| creator | Mahnke, C. Becket Mulreany, Michael P. Inafuku, Jill Abbas, Mazen Feingold, Brian Paolillo, Joseph A. |
| description | Because pediatric cardiologists can accurately diagnose innocent murmurs by physical exam alone, the authors developed a system for remote cardiac auscultation. They hypothesized that their system could accurately classify auscultatory findings as normal/innocent or pathologic. Patients undergoing evaluation underwent examination, echocardiography, and heart sound recording. Pediatric cardiologists evaluated the heart sounds and classified the case as either normal/innocent or pathologic. They reviewed103 heart sound data sets; 85% of the cases were accurately classified as either normal/innocent or pathologic, with a sensitivity of 82% and specificity of 86%. However, when accounting for clinical diagnosis, reviewer uncertainty, and ECG abnormalities, the sensitivity and specificity improved to 91% and 88% (accuracy 89%), respectively. Degree of certainty with the telecardiology diagnosis correlated with correct interpretation (P < .005). Digital heart sound recordings evaluated via telemedicine can distinguish normal/innocent murmurs from pathologic ones. Such a system could improve the use of pediatric cardiology services. |
| doi_str_mv | 10.1177/0009922808320596 |
| format | Article |
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Becket ; Mulreany, Michael P. ; Inafuku, Jill ; Abbas, Mazen ; Feingold, Brian ; Paolillo, Joseph A.</creator><creatorcontrib>Mahnke, C. Becket ; Mulreany, Michael P. ; Inafuku, Jill ; Abbas, Mazen ; Feingold, Brian ; Paolillo, Joseph A.</creatorcontrib><description>Because pediatric cardiologists can accurately diagnose innocent murmurs by physical exam alone, the authors developed a system for remote cardiac auscultation. They hypothesized that their system could accurately classify auscultatory findings as normal/innocent or pathologic. Patients undergoing evaluation underwent examination, echocardiography, and heart sound recording. Pediatric cardiologists evaluated the heart sounds and classified the case as either normal/innocent or pathologic. They reviewed103 heart sound data sets; 85% of the cases were accurately classified as either normal/innocent or pathologic, with a sensitivity of 82% and specificity of 86%. However, when accounting for clinical diagnosis, reviewer uncertainty, and ECG abnormalities, the sensitivity and specificity improved to 91% and 88% (accuracy 89%), respectively. Degree of certainty with the telecardiology diagnosis correlated with correct interpretation (P < .005). Digital heart sound recordings evaluated via telemedicine can distinguish normal/innocent murmurs from pathologic ones. Such a system could improve the use of pediatric cardiology services.</description><identifier>ISSN: 0009-9228</identifier><identifier>EISSN: 1938-2707</identifier><identifier>DOI: 10.1177/0009922808320596</identifier><identifier>PMID: 18626106</identifier><language>eng</language><publisher>Los Angeles, CA: SAGE Publications</publisher><subject>Acoustics ; Adolescent ; Adult ; Cardiology ; Child ; Child, Preschool ; Diagnosis, Differential ; Echocardiography ; EKG ; Evaluation ; Female ; Heart ; Heart Auscultation ; Heart diseases ; Heart Diseases - diagnosis ; Heart Murmurs - diagnosis ; Heart Sounds ; Humans ; Infant ; Male ; Pediatrics ; Sensitivity ; Sensitivity and Specificity ; Sound ; Sound recording ; Sound recordings ; Telemedicine ; User-Computer Interface</subject><ispartof>Clinical pediatrics, 2008-11, Vol.47 (9), p.919-925</ispartof><rights>Copyright Westminster Publications, Inc. 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Becket</creatorcontrib><creatorcontrib>Mulreany, Michael P.</creatorcontrib><creatorcontrib>Inafuku, Jill</creatorcontrib><creatorcontrib>Abbas, Mazen</creatorcontrib><creatorcontrib>Feingold, Brian</creatorcontrib><creatorcontrib>Paolillo, Joseph A.</creatorcontrib><title>Utility of Store-and-Forward Pediatric Telecardiology Evaluation in Distinguishing Normal From Pathologic Pediatric Heart Sounds</title><title>Clinical pediatrics</title><addtitle>Clin Pediatr (Phila)</addtitle><description>Because pediatric cardiologists can accurately diagnose innocent murmurs by physical exam alone, the authors developed a system for remote cardiac auscultation. They hypothesized that their system could accurately classify auscultatory findings as normal/innocent or pathologic. Patients undergoing evaluation underwent examination, echocardiography, and heart sound recording. Pediatric cardiologists evaluated the heart sounds and classified the case as either normal/innocent or pathologic. They reviewed103 heart sound data sets; 85% of the cases were accurately classified as either normal/innocent or pathologic, with a sensitivity of 82% and specificity of 86%. However, when accounting for clinical diagnosis, reviewer uncertainty, and ECG abnormalities, the sensitivity and specificity improved to 91% and 88% (accuracy 89%), respectively. Degree of certainty with the telecardiology diagnosis correlated with correct interpretation (P < .005). Digital heart sound recordings evaluated via telemedicine can distinguish normal/innocent murmurs from pathologic ones. Such a system could improve the use of pediatric cardiology services.</description><subject>Acoustics</subject><subject>Adolescent</subject><subject>Adult</subject><subject>Cardiology</subject><subject>Child</subject><subject>Child, Preschool</subject><subject>Diagnosis, Differential</subject><subject>Echocardiography</subject><subject>EKG</subject><subject>Evaluation</subject><subject>Female</subject><subject>Heart</subject><subject>Heart Auscultation</subject><subject>Heart diseases</subject><subject>Heart Diseases - diagnosis</subject><subject>Heart Murmurs - diagnosis</subject><subject>Heart Sounds</subject><subject>Humans</subject><subject>Infant</subject><subject>Male</subject><subject>Pediatrics</subject><subject>Sensitivity</subject><subject>Sensitivity and Specificity</subject><subject>Sound</subject><subject>Sound recording</subject><subject>Sound recordings</subject><subject>Telemedicine</subject><subject>User-Computer Interface</subject><issn>0009-9228</issn><issn>1938-2707</issn><fulltext>true</fulltext><rsrctype>article</rsrctype><creationdate>2008</creationdate><recordtype>article</recordtype><sourceid>EIF</sourceid><recordid>eNp1kdFLHDEQxoNU9Kq--ySBgm9bJ8ltdvNYrFcLooL6vMxlZ8_I7sYm2cq99U9vjjuwCGUeBmZ-3zcJH2OnAr4KUVUXAGCMlDXUSkJp9B6bCaPqQlZQfWKzzbrY7A_Z5xhfAISCUh2wQ1FrqQXoGfvzlFzv0pr7jj8kH6jAsS0WPrxhaPk9tQ5TcJY_Uk82j5zv_WrNr35jP2FyfuRu5N9dTG5cTS4-58ZvfRiw54vgB36P6XkjyRbvZteEIfEHP41tPGb7HfaRTnb9iD0trh4vr4ubux8_L7_dFFZplQrZ5u-RNAAWZC7UWJK1VtluaWqgbt4KbJdAUmpSqhLlsqTOlpoQrezm6oidb31fg_81UUzN4KKlvseR_BQbbapyrlWdwS8fwBc_hTG_rRFG1loooU2mYEvZ4GMM1DWvwQ0Y1o2AZpNN8zGbLDnbGU_Lgdp3wS6MDBRbIOKK_rn6P8O_dKKYMg</recordid><startdate>200811</startdate><enddate>200811</enddate><creator>Mahnke, C. 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Becket ; Mulreany, Michael P. ; Inafuku, Jill ; Abbas, Mazen ; Feingold, Brian ; Paolillo, Joseph A.</author></sort><facets><frbrtype>5</frbrtype><frbrgroupid>cdi_FETCH-LOGICAL-c363t-2d596e2900c02020a6a5eccc3cfb980ef4d1adb0e226e33715b5efc56eaac2f43</frbrgroupid><rsrctype>articles</rsrctype><prefilter>articles</prefilter><language>eng</language><creationdate>2008</creationdate><topic>Acoustics</topic><topic>Adolescent</topic><topic>Adult</topic><topic>Cardiology</topic><topic>Child</topic><topic>Child, Preschool</topic><topic>Diagnosis, Differential</topic><topic>Echocardiography</topic><topic>EKG</topic><topic>Evaluation</topic><topic>Female</topic><topic>Heart</topic><topic>Heart Auscultation</topic><topic>Heart diseases</topic><topic>Heart Diseases - diagnosis</topic><topic>Heart Murmurs - diagnosis</topic><topic>Heart Sounds</topic><topic>Humans</topic><topic>Infant</topic><topic>Male</topic><topic>Pediatrics</topic><topic>Sensitivity</topic><topic>Sensitivity and Specificity</topic><topic>Sound</topic><topic>Sound recording</topic><topic>Sound recordings</topic><topic>Telemedicine</topic><topic>User-Computer Interface</topic><toplevel>peer_reviewed</toplevel><toplevel>online_resources</toplevel><creatorcontrib>Mahnke, C. 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Becket</au><au>Mulreany, Michael P.</au><au>Inafuku, Jill</au><au>Abbas, Mazen</au><au>Feingold, Brian</au><au>Paolillo, Joseph A.</au><format>journal</format><genre>article</genre><ristype>JOUR</ristype><atitle>Utility of Store-and-Forward Pediatric Telecardiology Evaluation in Distinguishing Normal From Pathologic Pediatric Heart Sounds</atitle><jtitle>Clinical pediatrics</jtitle><addtitle>Clin Pediatr (Phila)</addtitle><date>2008-11</date><risdate>2008</risdate><volume>47</volume><issue>9</issue><spage>919</spage><epage>925</epage><pages>919-925</pages><issn>0009-9228</issn><eissn>1938-2707</eissn><abstract>Because pediatric cardiologists can accurately diagnose innocent murmurs by physical exam alone, the authors developed a system for remote cardiac auscultation. They hypothesized that their system could accurately classify auscultatory findings as normal/innocent or pathologic. Patients undergoing evaluation underwent examination, echocardiography, and heart sound recording. Pediatric cardiologists evaluated the heart sounds and classified the case as either normal/innocent or pathologic. They reviewed103 heart sound data sets; 85% of the cases were accurately classified as either normal/innocent or pathologic, with a sensitivity of 82% and specificity of 86%. However, when accounting for clinical diagnosis, reviewer uncertainty, and ECG abnormalities, the sensitivity and specificity improved to 91% and 88% (accuracy 89%), respectively. Degree of certainty with the telecardiology diagnosis correlated with correct interpretation (P < .005). Digital heart sound recordings evaluated via telemedicine can distinguish normal/innocent murmurs from pathologic ones. Such a system could improve the use of pediatric cardiology services.</abstract><cop>Los Angeles, CA</cop><pub>SAGE Publications</pub><pmid>18626106</pmid><doi>10.1177/0009922808320596</doi><tpages>7</tpages></addata></record> |
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| subjects | Acoustics Adolescent Adult Cardiology Child Child, Preschool Diagnosis, Differential Echocardiography EKG Evaluation Female Heart Heart Auscultation Heart diseases Heart Diseases - diagnosis Heart Murmurs - diagnosis Heart Sounds Humans Infant Male Pediatrics Sensitivity Sensitivity and Specificity Sound Sound recording Sound recordings Telemedicine User-Computer Interface |
| title | Utility of Store-and-Forward Pediatric Telecardiology Evaluation in Distinguishing Normal From Pathologic Pediatric Heart Sounds |
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