AIM:To investigate the accuracy and inter-observer variation of bowel sound assessment in patients with clinically suspected bowel obstruction.METHODS:Bowel sounds were recorded in patients with suspected bowel obstru...AIM:To investigate the accuracy and inter-observer variation of bowel sound assessment in patients with clinically suspected bowel obstruction.METHODS:Bowel sounds were recorded in patients with suspected bowel obstruction using a Littmann® Electronic Stethoscope. The recordings were processed to yield 25-s sound sequences in random order on PCs. Observers,recruited from doctors within the department,classified the sound sequences as either normal or pathological. The reference tests for bowel obstruction were intraoperative and endoscopic findings and clinical follow up. Sensitivity and specificity were calculated for each observer and compared between junior and senior doctors. Interobserver variation was measured using the Kappa statistic.RESULTS:Bowel sound sequences from 98 patients were assessed by 53(33 junior and 20 senior) doctors. Laparotomy was performed in 47 patients,35 of whom had bowel obstruction. Two patients underwent colorectal stenting due to large bowel obstruction. The median sensitivity and specificity was 0.42(range:0.19-0.64) and 0.78(range:0.35-0.98),respectively. T h e re wa s n o s i g n i f i c a n t d i ffe re n c e i n a cc u ra c y between junior and senior doctors. The median frequency with which doctors classified bowel sounds as abnormal did not differ significantly between patients with and without bowel obstruction(26% vs 23%,P = 0.08). The 53 doctors made up 1378 unique pairs and the median Kappa value was 0.29(range:-0.15-0.66).CONCLUSION:Accuracy and inter-observer agreement was generally low. Clinical decisions in patients with possible bowel obstruction should not be based on auscultatory assessment of bowel sounds.展开更多
This study delves into the life and significant contributions of René Théophile Hyacinthe Laennec,a prominent French physician of the 19^(th) century,and thoroughly examines his revolutionary creation,the st...This study delves into the life and significant contributions of René Théophile Hyacinthe Laennec,a prominent French physician of the 19^(th) century,and thoroughly examines his revolutionary creation,the stethoscope.Laennec’s innovative spirit not only revolutionized medical diagnosis during his time but also left a lasting imprint on the broader field of medicine,influencing healthcare for generations.This extensive inquiry covers various aspects,including his historical context,the development of the stethoscope,its profound implications for medical diagnosis,and its enduring impact on the history of medicine.展开更多
Congenital heart disease(CHD),the most prevalent congenital ailment,has seen advancements in the“dual indi-cator”screening program.This facilitates the early-stage diagnosis and treatment of children with CHD,subse-...Congenital heart disease(CHD),the most prevalent congenital ailment,has seen advancements in the“dual indi-cator”screening program.This facilitates the early-stage diagnosis and treatment of children with CHD,subse-quently enhancing their survival rates.While cardiac auscultation offers an objective reflection of cardiac abnormalities and function,its evaluation is significantly influenced by personal experience and external factors,rendering it susceptible to misdiagnosis and omission.In recent years,continuous progress in artificial intelli-gence(AI)has enabled the digital acquisition,storage,and analysis of heart sound signals,paving the way for intelligent CHD auscultation-assisted diagnostic technology.Although there has been a surge in studies based on machine learning(ML)within CHD auscultation and diagnostic technology,most remain in the algorithmic research phase,relying on the implementation of specific datasets that still await verification in the clinical envir-onment.This paper provides an overview of the current stage of AI-assisted cardiac sounds(CS)auscultation technology,outlining the applications and limitations of AI auscultation technology in the CHD domain.The aim is to foster further development and refinement of AI auscultation technology for enhanced applications in CHD.展开更多
文摘AIM:To investigate the accuracy and inter-observer variation of bowel sound assessment in patients with clinically suspected bowel obstruction.METHODS:Bowel sounds were recorded in patients with suspected bowel obstruction using a Littmann® Electronic Stethoscope. The recordings were processed to yield 25-s sound sequences in random order on PCs. Observers,recruited from doctors within the department,classified the sound sequences as either normal or pathological. The reference tests for bowel obstruction were intraoperative and endoscopic findings and clinical follow up. Sensitivity and specificity were calculated for each observer and compared between junior and senior doctors. Interobserver variation was measured using the Kappa statistic.RESULTS:Bowel sound sequences from 98 patients were assessed by 53(33 junior and 20 senior) doctors. Laparotomy was performed in 47 patients,35 of whom had bowel obstruction. Two patients underwent colorectal stenting due to large bowel obstruction. The median sensitivity and specificity was 0.42(range:0.19-0.64) and 0.78(range:0.35-0.98),respectively. T h e re wa s n o s i g n i f i c a n t d i ffe re n c e i n a cc u ra c y between junior and senior doctors. The median frequency with which doctors classified bowel sounds as abnormal did not differ significantly between patients with and without bowel obstruction(26% vs 23%,P = 0.08). The 53 doctors made up 1378 unique pairs and the median Kappa value was 0.29(range:-0.15-0.66).CONCLUSION:Accuracy and inter-observer agreement was generally low. Clinical decisions in patients with possible bowel obstruction should not be based on auscultatory assessment of bowel sounds.
文摘This study delves into the life and significant contributions of René Théophile Hyacinthe Laennec,a prominent French physician of the 19^(th) century,and thoroughly examines his revolutionary creation,the stethoscope.Laennec’s innovative spirit not only revolutionized medical diagnosis during his time but also left a lasting imprint on the broader field of medicine,influencing healthcare for generations.This extensive inquiry covers various aspects,including his historical context,the development of the stethoscope,its profound implications for medical diagnosis,and its enduring impact on the history of medicine.
基金supported by Jiangsu Provincial Health Commission(Grant No.K2023036).
文摘Congenital heart disease(CHD),the most prevalent congenital ailment,has seen advancements in the“dual indi-cator”screening program.This facilitates the early-stage diagnosis and treatment of children with CHD,subse-quently enhancing their survival rates.While cardiac auscultation offers an objective reflection of cardiac abnormalities and function,its evaluation is significantly influenced by personal experience and external factors,rendering it susceptible to misdiagnosis and omission.In recent years,continuous progress in artificial intelli-gence(AI)has enabled the digital acquisition,storage,and analysis of heart sound signals,paving the way for intelligent CHD auscultation-assisted diagnostic technology.Although there has been a surge in studies based on machine learning(ML)within CHD auscultation and diagnostic technology,most remain in the algorithmic research phase,relying on the implementation of specific datasets that still await verification in the clinical envir-onment.This paper provides an overview of the current stage of AI-assisted cardiac sounds(CS)auscultation technology,outlining the applications and limitations of AI auscultation technology in the CHD domain.The aim is to foster further development and refinement of AI auscultation technology for enhanced applications in CHD.
