Respiratory noises: how useful are they clinically?
Although clinicians place considerable weight on the identification of the various forms of noisy breathing, there are serious questions regarding both the accuracy (validity) and the reliability (repeatability) of these noises. To avoid diagnostic errors, clinicians need to consider the whole constellation of symptoms and signs, and not focus on the specific "type" of noise. Given the high error rate with "parent-reported wheeze" there is a need to reexamine the extensive literature on the epidemiology of wheeze in infants and young children, because parent-reported wheeze is unconfirmed by a clinician. It is obvious we need more high-quality research evidence to derive better evidence on the clinical utility of these noises, and their natural history.
Mellis
Craig
C
Central Clinical School, University of Sydney, Royal Prince Alfred Hospital, Sydney, NSW 2006, Australia. c.mellis@usyd.edu.au
D000162:Acoustics; D000402:Airway Obstruction / Q000150:complications / Q000175:diagnosis; D001249:Asthma / Q000150:complications / Q000175:diagnosis; D002648:Child; D002675:Child, Preschool; D003937:Diagnosis, Differential; D019317:Evidence-Based Medicine; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007223:Infant; D010290:Parents; D011379:Prognosis; D015203:Reproducibility of Results; D012135:Respiratory Sounds / Q000145:classification* / Q000175:diagnosis / Q000209:etiology*; D012140:Respiratory Tract Diseases / Q000150:complications* / Q000175:diagnosis*; D009626:Terminology as Topic; D014741:Video Recording