Evaluation of Internet-Connected Real-Time Remote Auscultation: An Open-Label Randomized Controlled Pilot Trial

Abstract

The utility of remote auscultation was unknown. This study aimed to evaluate internet-connected real-time remote auscultation using cardiopulmonary simulators. In this open-label randomized controlled trial, the physicians were randomly assigned to the real-time remote auscultation group (intervention group) or the classical auscultation group (control group). After the training session, the participants had to classify the ten cardiopulmonary sounds in random order as the test session. In both sessions, the intervention group auscultated with an internet-connected electronic stethoscope. The control group performed direct auscultation using a classical stethoscope. The total scores for correctly identified normal or abnormal cardiopulmonary sounds were 97/100 (97%) in the intervention group and 98/100 (98%) in the control group with no significant difference between the groups (p > 0.99). In cardiac auscultation, the test score in the control group (94%) was superior to that in the intervention group (72%, p < 0.05). Valvular diseases were not misclassified as normal sounds in real-time remote cardiac auscultation. The utility of real-time remote cardiopulmonary auscultation using an internet-connected electronic stethoscope was comparable to that of classical auscultation. Classical cardiac auscultation was superior to real-time remote auscultation. However, real-time remote cardiac auscultation is useful for classifying valvular diseases and normal sounds.