title: Comparison of conventional and sensor-based electronic stethoscopes in detecting cardiac murmurs of dogs.
abstract: OBJECTIVE
  Cardiac auscultation is one of the most important parts of the cardiological examination traditionally performed with acoustic stethoscopes. The aim of this study was to compare the sensitivities and the diagnostic capabilities of traditional and electronic stethoscopes in detecting canine heart murmurs.
  
  
  METHODS
  The study was performed on 21 dogs referred for cardiologic examination with suspected heart murmurs. Six out of these dogs had cardiac murmurs bilaterally. Cardiac auscultation was performed independently by a final-year veterinary student (AB=I1) and by an experienced clinician (KV=I2), both using a traditional and a Welch Allyn Meditron electronic sensor-based stethoscope. Final diagnoses were established by echocardiography and by digital phonocardiography.
  
  
  RESULTS
  Correct detection of a murmur was made by I1 with a traditional stethoscope in 20/27 (74.0%) of the suspected murmurs (p=0.30, kappa[κ] =0.2) and with the electronic stethoscope in 26/27 (96.3%), respectively (p=0.0013, κ=0.75). I2 correctly detected the murmurs with the traditional stethoscope in 25/27 (92.6%) cases (p=0.0013, κ=0.75) and with the electronic stethoscope in all 27/27 (100%) cases (p=0.00012, κ=1). Agreements of murmur intensity gradings between traditional and electronic stethoscopes were highly significant (I1: p=6.9´10⁻⁸; κ=0.79), (I2: p=5.2´10⁻¹¹; κ=0.92). When grading the murmurs with the traditional stethoscope, there was a significant agreement between I1 and I2 (p=2.9´10⁻⁷; κ=0.79), being even higher with the electronic stethoscope (p=1.1´10⁻¹¹; κ=0.92).
  
  
  CONCLUSIONS
  The electronic stethoscope was more sensitive than the traditional one in detecting and grading cardiac murmurs being especially useful for I1 with less experience. However, it can be suggested to use a traditional and an electronic stethoscopes simultaneously to optimally utilize their advantages.
authors.affiliation: Department and Clinic Internal Medicine, Szent István University, Budapest, Hungary. Voros.Karoly@aotk.szie.hu
authors.forename: K
authors.initials: K
authors.lastname: Vörös
authors.forename: A
authors.initials: A
authors.lastname: Bonnevie
authors.forename: J
authors.initials: J
authors.lastname: Reiczigel
mesh_terms: D000669:Amplifiers, Electronic / Q000662:veterinary; D000818:Animals; D004283:Dog Diseases / Q000175:diagnosis* / Q000503:physiopathology; D004285:Dogs; D004452:Echocardiography / Q000379:methods / Q000662:veterinary; D006326:Heart Auscultation / Q000295:instrumentation / Q000592:standards / Q000662:veterinary*; D006337:Heart Murmurs / Q000175:diagnosis / Q000503:physiopathology / Q000662:veterinary*; D015588:Observer Variation; D010701:Phonocardiography / Q000662:veterinary; D012680:Sensitivity and Specificity; D019023:Stethoscopes / Q000145:classification / Q000592:standards / Q000662:veterinary*