Validation of remote cardiopulmonary examination in patients with heart failure with a videophone-based system.
BACKGROUND
The aim of this study was to evaluate feasibility and accuracy of a videophone-based system for remote cardiopulmonary examination of patients with heart failure.


RESULTS
Fifty patients were examined by 2 cardiologists, 1 with a conventional stethoscope and 1 remotely with a videophone-based method, employing an electronic stethoscope and transmitting through an integrated services digital network line. During both sessions, the cardiologists filled out a 27-item questionnaire, which was then compared; concordance between standard and remote examination was evaluated. In 92% of patients, electronic and acoustic auscultation concurred. Only in 3 patients (4%) did teleauscultation not permit a correct interpretation of lung examination. In one patient, bilateral fine crepitant rales were not detected during teleauscultation. Conversely, in the second, patient bilateral fine crepitant rales were recognized during teleauscultation, which were not confirmed during real-life auscultation. In the third nonconcordant patient, moderate-degree wheezing was not detected during teleauscultation. Fine crepitant rales were present at the lungs lower fields in 12 and wheezing in 3 additional patients, and were always correctly identified during teleauscultation. Overall, sensitivity, specificity, positive, and negative predictive value of remote lung auscultation were 88%, 97%, 94%, and 94%, respectively.


CONCLUSIONS
Remote cardiopulmonary examination appears as a feasible method for assessing patients with heart failure. Telestethoscopy can therefore be reliably used in the context of comprehensive telecare programs.
Fragasso
Gabriele
G
Clinical Cardiology-Heart Failure Unit, Istituto Scientifico San Raffaele, Milano, Italy.
Cuko
Amarild
A
Spoladore
Roberto
R
Montano
Chiara
C
Palloshi
Altin
A
Silipigni
Carmen
C
Monti
Giovanni
G
Castelli
Alberto
A
Padiglione
Fabio
F
Leonida
Antonio
A
Margonato
Alberto
A
D000368:Aged; D001314:Auscultation / Q000295:instrumentation* / Q000379:methods*; D004868:Equipment Failure; D005260:Female; D006333:Heart Failure / Q000175:diagnosis* / Q000628:therapy; D006801:Humans; D007558:Italy; D008297:Male; D019114:Remote Consultation / Q000295:instrumentation* / Q000379:methods*; D015203:Reproducibility of Results; D012680:Sensitivity and Specificity; D019023:Stethoscopes; D049269:Videoconferencing / Q000295:instrumentation*