Attention is being turned to enhancing one of the most basic of medical tools, the stethoscope. The question is can we improve our ability to hear and interpret the sounds produced by the human body with artificial intelligence (AI)? . We have seen this concept applied in radiology where the machine matches up favorably with the radiologist, and in cardiology with arrhythmia detection and pattern reading of electrocardiograms by computer. But, can AI be applied to the basic skill of auscultation?
To examine this question, we need to go back two centuries to the "ear trumpet", a tube and earpiece, first used by the French physician, Rene Laennec in 1816, which revolutionized the medical examination. It took more than a century before this device was improved to the binaural device that we are familiar with today. About a decade ago, the electronic stethoscope was introduced to provide amplification.
Amplification, however, did not improve accuracy. Studies have shown that only 60% to 80% of the time physicians can hear a heart murmur when it is present.. When making rounds with students, I would often hear a heart sound or murmur that was missed by those with better hearing. The reason was that my experience had taught me that a sound might be present and if I focused and concentrated on hearing it, I would detect it. After pointing it out, the student would return of the patient and could then hear the sound or murmur.