Heart murmurs recorded by a sensor based electronic stethoscope and e-mailed for remote assessment

Area of Science:

• Pediatric Cardiology
• Medical Technology
• Telehealth

Background:

• Heart murmurs are common in children, often requiring specialist referral.
• A remote auscultation service using telemedicine was established for pediatric heart murmurs.
• This service aimed to improve access in a large, sparsely populated referral area.

Purpose of the Study:

• To evaluate the clinical quality and effectiveness of telemedicine for pediatric heart murmur assessment.
• To determine the accuracy and efficiency of remote auscultation by cardiologists.

Main Methods:

• Heart sounds from 47 children (no murmur, innocent, or pathological murmurs) were recorded using a digital stethoscope.
• Recordings were emailed and assessed by four cardiologists.
• Data collected included assessment time, diagnostic category, certainty, and referral recommendations.

Main Results:

• Mean assessment time per case was 2.1 minutes.
• High diagnostic accuracy was achieved: mean sensitivity 89.7%, specificity 98.2%.
• Low inter-observer (kappa 0.81) and intra-observer (kappa 0.87) variability was observed.

Conclusions:

• Telemedical referral for pediatric heart murmurs is a safe and time-saving method.
• Remote assessment by cardiologists demonstrates high accuracy.
• Skilled auscultation via telemedicine effectively identifies innocent murmurs, potentially reducing unnecessary referrals.