Engelsk titel: May heart murmurs be assessed by telemedicine?
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Författare:
Dahl LB
;
Hasvold P
;
Arild E
;
Hasvold T
Email: lauritz.dahl@unn.no
Språk: Nor
Antal referenser: 32
Dokumenttyp:
Artikel
UI-nummer: 03121823
Sammanfattning
BACKGROUND : Children often have heart murmurs; referral to a specialist is common. A service for remote auscultation of heart murmurs was established in which heart sounds and short texts were sent as attachment to e-mails. Our aim was to assess the quality of this method.
MATERIAL AND METHODS : Heart sounds from 47 patients with no murmur (n = 7), innocent murmurs (n = 20), or with pathological murmurs (n = 20) were recorded using a sensor-based stethoscope and e-mailed to a computer. The sounds were repeated giving 100 cases, randomly distributed on a CD. Four specialists categorised the cases as having "no murmur", "innocent murmur", or "pathological murmur", recorded assessment time, degree of certainty, and need for referral.
RESULTS : On average 2.1 minutes were spent on each case. Mean sensitivity and specificity were 90% and 98%, respectively. Inter- and intra-observer variability were low (kappa 0.81 and 0.87). 93% of cases with a pathological murmur and 13% with an innocent murmur were recommended for referral.
INTERPRETATION : Telemedical referral of children with heart murmurs to a cardiologist is safe, reduces travelling, and saves time. Skilled auscultation is adequate to detect those with innocent murmurs.