A Low-Cost, Ear-Contactless Electronic Stethoscope Powered by Raspberry Pi for Auscultation of Patients With COVID-19: Prototype Development and Feasibility Study

Digital auscultation in clear and present threat of novel respiratory infectious disease: a narrative review

The coronavirus disease 2019 pandemic has underscored the limitations of traditional diagnostic methods, particularly in ensuring the safety of healthcare workers and patients during infectious outbreaks. Smartphone-based digital stethoscopes enhanced with artificial intelligence (AI) have emerged as potential tools for addressing these challenges by enabling remote, efficient, and accessible auscultation. Despite advancements, most existing systems depend on additional hardware and external processing, increasing costs and complicating deployment. This review examines the feasibility and limitations of smartphone-based digital stethoscopes powered by AI, focusing on their ability to perform real-time analyses of audible and inaudible sound frequencies. We also explore the regulatory barriers, data storage challenges, and diagnostic accuracy issues that must be addressed to facilitate broader adoption. The implementation of these devices in veterinary medicine is discussed as a practical step toward refining their applications. With targeted improvements and careful consideration of existing limitations, smartphone-based AI stethoscopes could enhance diagnostic capabilities in human and animal healthcare settings.

Frugal engineering-inspired wearable augmented reality goggle system enables fluorescence-guided cancer surgery

Disparities in surgical outcomes often result from subjective decisions dictated by surgical training, experience, and available resources. To improve outcomes, surgeons have adopted advancements in robotics, endoscopy, and intra-operative imaging including fluorescence-guided surgery (FGS), which highlights tumors and anatomy in real-time. However, technical, economic, and logistic challenges hinder widespread adoption of FGS beyond high-resource centers. To overcome these impediments, we combined laser diodes, Raspberry Pi cameras and computers, off-the-shelf optical components, and 3D-printed parts to make a battery-powered, compact, dual white light and NIR imaging system that has comparable performance to existing bulkier, pricier, and wall-powered technologies. We combined these components with off-the-shelf augmented reality (AR) glasses to create a fully-wearable fluorescence imaging AR Raspberry Pi-based goggle system (FAR-Pi) and validated performance in a pre-clinical cancer surgery model. Novel device design ensures distance-independent coalignment between real and augmented views. As an open-source, affordable, and adaptable system, FAR-Pi is poised to democratize access to FGS and improve health outcomes worldwide.

New Technological Approaches to the Organization of the Work of Medical Personnel Performing Auscultation of Patients with COVID-19

Due to the COVID-19 epidemic, the challenge of introducing methods for investigating patients reducing or eliminating the probability of infection of medical staff is currently relevant. This article provides an analytical review of new technological approaches to organizing the work of medical personnel in carrying out auscultation of patients with COVID-19. The development and approval of such technologies is shown to have started around the world. The ubiquitous and large-scale introduction of these methods into medical practice therefore seems expedient.

A comparison of the power of breathing sounds signals acquired with a smart stethoscope from a cohort of COVID-19 patients at peak disease, and pre-discharge from the hospital

Objectives

To characterize the frequencies of breathing sounds signals (BS) in COVID-19 patients at peak disease and pre-discharge from hospitalization using a Smart stethoscope.

Methods

Prospective cohort study conducted during the first COVID-19 wave (April-August 2020) in Israel. COVID-19 patients (n = 19) were validated by SARS-Cov-2 PCR test. The healthy control group was composed of 153 volunteers who stated that they were healthy. Power of BS was calculated in the frequency ranges of 0–20, 0–200, and 0–2000 Hz.

Results

The power calculated over frequency ranges 0–20, 20–200, and 200–2000 Hz contributed approximately 45%, 45%, and 10% to the total power calculated over the range 0–2000 Hz, respectively. Total power calculated from the right side of the back showed an increase of 45–80% during peak disease compared with the healthy controls (p < 0.05). The power calculated over the back, in the infrasound range, 0–20 Hz, and not in the 20–2000 Hz range, was greater for the healthy controls than for patients. Using all 3 ranges of frequencies for distinguishing peak disease from healthy controls resulted in sensitivity and specificity of 84% and 91%, respectively. Omitting the 0–20 Hz range resulted in sensitivity and specificity of 74% and 67%, respectively.

Discussion

The BS power acquired from COVID-19 patients at peak disease was significantly greater than that at pre-discharge from the hospital. The infrasound range had a significant contribution to the total power. Although the source of the infrasound is not presently clear, it may serve as an automated diagnostic tool when more clinical experience is gained with this method.

Cylindrical Tube Stethoscopes: The Value of Practical Equipment in the Management of Patients with Infectious Diseases

Background

The COVID-19 pandemic has continued for more than two years since its outbreak. Due to the clinical auscultation needs of doctors when wearing airtight protective clothing, a cylindrical tube stethoscope was proposed to address this problem. However, the idea has been questioned by some experts.

Methods

To address these questions, we performed three-part experiments using cylindrical tube stethoscopes. First, we performed laboratory tests to detect the sound intensity from a cylindrical tube stethoscope. Second, we improved the cylindrical tube stethoscope to achieve better results. Third, we revealed the difference in the auscultation effects of the cylindrical tube stethoscope and a conventional professional 3 M stethoscope.

Results

From these experiments, we found that a narrow cylindrical tube with a diameter of 4.2 cm and a length of 20 cm equipped with a silicone gasket better auscultation of heart sounds. A cylindrical tube stethoscope and a 3 M stethoscope were used to perform stethoscope tests on 10 volunteers. The alveolar lung sounds were 44.478 decibels vs 49.529 decibels, the heart sounds were 46.631 decibels vs 41.109 decibels, and the intestinal sounds were 40.132 decibels vs 43.787 decibels, respectively.

Conclusion

This improved cylindrical tube stethoscope can meet the auscultation requirements for cardiorespiratory and abdominal diagnosis during infectious disease pandemics.

Research on Digital Technology Use in Cardiology: Bibliometric Analysis

Background

Digital technology uses in cardiology have become a popular research focus in recent years. However, there has been no published bibliometric report that analyzed the corresponding academic literature in order to derive key publishing trends and characteristics of this scientific area.

Objective

We used a bibliometric approach to identify and analyze the academic literature on digital technology uses in cardiology, and to unveil popular research topics, key authors, institutions, countries, and journals. We further captured the cardiovascular conditions and diagnostic tools most commonly investigated within this field.

Methods

The Web of Science electronic database was queried to identify relevant papers on digital technology uses in cardiology. Publication and citation data were acquired directly from the database. Complete bibliographic data were exported to VOSviewer, a dedicated bibliometric software package, and related to the semantic content of titles, abstracts, and keywords. A term map was constructed for findings visualization.

Results

The analysis was based on data from 12,529 papers. Of the top 5 most productive institutions, 4 were based in the United States. The United States was the most productive country (4224/12,529, 33.7%), followed by United Kingdom (1136/12,529, 9.1%), Germany (1067/12,529, 8.5%), China (682/12,529, 5.4%), and Italy (622/12,529, 5.0%). Cardiovascular diseases that had been frequently investigated included hypertension (152/12,529, 1.2%), atrial fibrillation (122/12,529, 1.0%), atherosclerosis (116/12,529, 0.9%), heart failure (106/12,529, 0.8%), and arterial stiffness (80/12,529, 0.6%). Recurring modalities were electrocardiography (170/12,529, 1.4%), angiography (127/12,529, 1.0%), echocardiography (127/12,529, 1.0%), digital subtraction angiography (111/12,529, 0.9%), and photoplethysmography (80/12,529, 0.6%). For a literature subset on smartphone apps and wearable devices, the Journal of Medical Internet Research (20/632, 3.2%) and other JMIR portfolio journals (51/632, 8.0%) were the major publishing venues.

Conclusions

Digital technology uses in cardiology target physicians, patients, and the general public. Their functions range from assisting diagnosis, recording cardiovascular parameters, and patient education, to teaching laypersons about cardiopulmonary resuscitation. This field already has had a great impact in health care, and we anticipate continued growth.

Evaluation of the electronic stethoscope (FONODOC) as a cardiac screening tool during the preoperative evaluation of children

Background and Aims:

An electronic stethoscope with an inbuilt phonocardiogram is a potentially useful tool for paediatric cardiac evaluation in a resource-limited setting. We aimed to compare the acoustic and electronic stethoscopes with respect to the detection of murmurs as compared to the transthoracic echocardiogram (TTE).

Methods:

This was an observational study. Fifty children aged 0–12 years with congenital heart diseases (CHDs) and 50 without CHD scheduled for echocardiography were examined using both stethoscopes. The findings were corroborated with clinical findings and compared with the echocardiography report.

Results:

Among the 50 cases without CHD, no murmur was detected using either of the stethoscopes. This was in agreement with TTE findings. The calculated specificity of both stethoscopes was 100%. Amongst the 50 cases with CHD, the electronic stethoscope picked up murmurs in 32 cases and missed 18 cases. The acoustic stethoscope picked up murmurs in 29 cases and missed 21 cases. Thus, the sensitivity of electronic and acoustic stethoscopes as compared to TTE was calculated to be 64% and 58%, respectively. The positive predictive value of the electronic stethoscope as compared to TTE was 100% while the negative predictive value was 73%. The kappa statistic was 0.93 suggesting agreement in 93%. Mc-Nemar’s test value was 0.24 suggesting that the electronic stethoscope did not offer any advantage over the acoustic stethoscope for the detection of CHD in children.

Conclusion:

A comparison of the electronic stethoscope with an acoustic stethoscope suggests that the rate of detection of CHD with both stethoscopes is similar and echocardiography remains the gold standard.

The impact of a digital wheeze detector on parental disease management of pre-school children suffering from wheezing-a pilot study

BACKGROUND

Viral airway infections are a major reason for doctor's visits at pre-school age, especially when associated with wheezing. While proper treatment requires adequate recognition of airway obstruction, caretakers are often struggling with this judgment, consequently leading to insufficient or late treatment and an unnecessary discomfort of the patient. Digital technologies may serve to support parental decision taking. The aim of the present pilot study is to acquire data on the feasibility of recruitment and observation procedures for a randomized controlled trial on the impact of a digital wheeze detector in a home management setting of pre-school wheezing.

METHODS

This single-armed pilot study enrolled patients with a doctor's diagnosis of wheezing aged 9 to 72 months. Participants were asked to use a digital wheeze detector (WheezeScan, Omron Healthcare, Japan) 2×/day for 30 days and record the child's respiratory symptoms, detection of wheezing, and medication intake via an electronic diary (eDiary) app. Demographic and clinical data were collected at the recruitment visit. The asthma control test and the Parent Asthma Management Self-Efficacy Scale (PAMSES) were assessed both, at recruitment and follow-up.

RESULTS

Twenty families were recruited and completed the monitoring. All but one completed the follow-up after 30 days. The recruitment procedures were feasible, and adherence to daily monitoring reached an average of 81%. The use of the wheeze detector was rated as uncomplicated. Parents detected wheezing without digital support in only 22/708 (3.1%) of the recorded events. By contrast, the wheeze detector indicated an airway obstruction in 140/708 (19.8%) of the recordings.

CONCLUSION

In parallel to feasible recruitment procedures, we observed good usability of the wheeze detection device and high adherence to eDiary recording. The positive outcomes show that the WheezeScan may empower parents by increasing their capacity for wheeze detection. This deserves to be investigated in a larger randomized controlled trial.

Automated lung sound analysis using the LungPass platform: a sensitive and specific tool for identifying lower respiratory tract involvement in COVID-19

Lower respiratory tract (LRT) involvement, observed in about 20% of patients suffering from coronavirus disease 2019 (COVID-19), is associated with a more severe clinical course, adverse outcomes and long-term sequelae [1, 2]. By pointing out people at risk of deterioration, early identification of LRT involvement could facilitate targeted and timely administration of treatments that could alter short- and long-term disease outcomes [3]. While imaging represents the gold standard diagnostic test for LRT involvement, it is associated with a potentially avoidable radiation burden and may not be easily accessible in some treatment settings, such as primary care [4]. Alternatively, oxygen desaturation appears to be a specific, but not sensitive marker, since ground glass changes or consolidation are often observed in the absence of hypoxia [5–7]. The sensitivity of chest auscultation in identifying LRT involvement has been evaluated in limited populations and varies [8, 9], possibly to some extent due to variable skill among the assessors.

Automated lung sound analysis using the #LungPass platform is a sensitive and specific tool for identifying lower respiratory tract involvement in COVID-19https://bit.ly/3tyAgOD