Purpose of Study: The delivery of primary care is a major challenge in the developing world due to a combination of factors that include an insufficient number of health workers per capita and poor infrastructure. This project aims to determine whether remote screening for cardiac abnormalities using a low-cost electronic stethoscope and existing mobile phone infrastructure is feasible in order to partially address this problem. Methods Used: A low-cost ($30) electronic stethoscope was developed using off-the-shelf electronic components and commercially available bell units. Java software was developed both for Android mobile phones and for laptop computers. Recorded stethoscope signals collected using the software was relayed to a Cloud-based database, which was developed using the Google App Engine. The devices were tested for usability by a team of medical students who evaluated them at several primary, secondary and tertiary field sites in India. Recordings were made on site and later uploaded to the Cloud database. On-site examinations were also performed of all patients including conventional auscultation, and abnormal findings were included in the database. Summary of Results: Recordings were made of 26 patients with abnormal findings (including patients with rheumatic heart disease, atrial septal defects, ventricular septal defects, and mitral regurgitation). In these patients, the abnormality was detectable by auscultation with a conventional stethoscope, and remotely by listening to the electronic recording made by the prototype. However, precise categorization of abnormal sounds was not always possible using the recordings. Conclusions: The initial field tests demonstrate that a low-cost electronic stethoscope may be effective for remote screening in the developing world, with the proviso that complete remote diagnosis may not be possible in some cases. The electronic stethoscopes can be deployed in areas where direct primary care is not available; this would allow patients to make more informed decisions about the urgency of obtaining medical advice in person. Further trials are required to determine the sensitivity and reliability of this remote screening technique in order to fully validate its application for this purpose.
@inproceedings{sarma2012wsmrf,
author = {Sarma, K. V. and Xia, P. and Lin, J. and Tan, A. and Bunn, J. and Chandy, K.},
booktitle = {Western Student Medical Research Forum},
title = {{Low-cost Cloud-based Remote Auscultation}},
year = {2012},
}