title: Efficiency, sensitivity and specificity of automated auscultation diagnosis device for detection and discrimination of cardiac murmurs in children.
abstract: OBJECTIVE
  Intelligent electronic stethoscopes and computer-aided auscultation systems have highlighted a new era in cardiac auscultation in children. Several collaborative multidisciplinary researches in this field are performed by physicians and computer specialists. Recently, a novel medical software device, Automated Auscultation Diagnosis Device (AADD), has been reported with intelligent diagnosing ability to differentiate cardiac murmur from breath sounds in children with normal and abnormal hearts due to congenital heart disease. The aim of this study is to determine efficiency, sensitivity and specificity of the diagnoses made by this AADD in children with and without cardiac disease.
  
  
  METHODS
  We performed a cross-sectional study to determine efficiency, sensitivity and specificity of diagnoses made by AADD. Our patient population was two groups of children with and without cardiac disease(563 patients and 50 normal). SPSS version 16 was used to calculate sensitivity, specificity and efficiency and descriptive analysis.
  
  
  RESULTS
  Using cardiac sound recording in four conventional cardiac areas of auscultation (including aortic, pulmonary, tricuspid and mitral), AADD proved to have a ≥90% sensitivity, specificity and efficiency for making the correct diagnosis in children with heart disease and 100% diagnostic accuracy in children with normal hearts either with or without innocent murmurs.
  
  
  CONCLUSIONS
  Considering the high sensitivity, specificity and efficiency of AADD for making the correct diagnosis, application of this software is recommended for family physicians to enhance proper and timely patients' referral to pediatric cardiologists in order to provide better diagnostic facilities for pediatric patients who live in deprived and underserved rural areas with lack access to pediatric cardiologists.
authors.affiliation: Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran ; Children's Medical Center, Pediatrics center of Excellence, Tehran, Iran.
authors.forename: Armen
authors.initials: A
authors.lastname: Kocharian
authors.affiliation: CAPIS Biomedical Research Department, Mons, Belgium.
authors.forename: Amir-Ahmad
authors.initials: AA
authors.lastname: Sepehri
authors.affiliation: Amirkabir University of Technology, Tehran, Iran.
authors.forename: Azin
authors.initials: A
authors.lastname: Janani
authors.affiliation: Department of Pediatrics, Tehran University of Medical Sciences, Tehran, Iran ; Children's Medical Center, Pediatrics center of Excellence, Tehran, Iran.
authors.forename: Elaheh
authors.initials: E
authors.lastname: Malakan-Rad
keywords: Auscultation; Computer-Assisted Design; Computer-Assisted Diagnosis; Computerized Medical Records System