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Monthly Archives: February 2016

New electronic stethoscope and app diagnose lung conditions feedly

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Interesting development arising from visual mapping of lung sounds.

New electronic stethoscope and app diagnose lung conditions
// Accelerating Intelligence News

1. Electronic stethoscope records patient’s breathing. Lung sounds are sent to a phone or tablet and analyzed by an app. 3. Medical professionals can listen and see the results in real time from any location to diagnose the patient. (credit: Hiroshima University)

The traditional stethoscope has just been superseded by an electronic stethoscope and an app called Respiratory Sounds Visualizer, which can automatically classify lung sounds into five common diagnostic categories.* The system was developed by three physician researchers at Hiroshima University and Fukushima Medical University in collaboration with Pioneer Corporation.

The respiratory specialist doctors recorded and classified lung sounds of 878 patients, then turned these diagnoses into templates to create a mathematical formula that evaluates the length, frequency, and intensity of lung sounds. The resulting app can recognize the sound patterns consistent with five different respiratory diagnoses.

How the Respiratory Sounds Visualizer app works

Based on an analysis of the characteristics of respiratory sounds, the Respiratory Sounds Visualizer app generates this diagnostic chart. The total area in red represents the overall volume of sound, and the proportion of red around each line from the center to each vertex represents the proportion of the overall sound that each respiratory sound contributes. (credit: Shinichiro Ohshimo et al./Annals of Internal Medicine)

The app analyzes the lung sounds and maps them on a five-sided chart. Each of the five axes represents one of the five types of lung sounds. Doctors and patients can see the likely diagnosis based on the length of the axis covered in red.

A doctor working in less-than-ideal circumstances, such as a noisy emergency room or field hospital, could rely on the computer program to “hear” what they might otherwise miss, and the new system could help student doctors learn.

The results from the computer program are simple to interpret and can be saved and shared electronically. In the future, this convenience may allow patients to track and record their own lung function during chronic conditions, like chronic obstructive pulmonary disease (COPD) or cystic fibrosis.

“We plan to use the electronic stethoscope and Respiratory Sounds Visualizer with our own patients after further improving [the mathematical calculations]. We will also release the computer program as a downloadable application to the public in the near future,” said Shinichiro Ohshimo, MD, PhD, an emergency physician in the Department of Emergency and Critical Care Medicine at Hiroshima University Hospital and one of the researchers involved in developing the technology.

* Despite advances in technology, respiratory physiology still depends primarily on chest auscultation, [which is] subjective and requires sufficient training. In addition, identification of the five respiratory sounds specified by the International Lung Sounds Association is difficult because their frequencies overlap:The frequency of normal respiratory sound is 100 to 1000 Hz, wheeze is 100 to 5000 Hz, rhonchus is 150 Hz, coarse crackle is 350 Hz, and fine crackle is 650 Hz. — Shinichiro Ohshimo et al./Annals of Internal Medicine.


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OHMES Symposium Pearls

Assessments are diagnostic tests. If your test does not change management, why do the test? We validate interpretations, not tests.

Develop a program of assessment. Piece together small chunks. Each has less validity but the whole has more.

Find more pearls from the OHMES Symposium on Twitter.

Flashy gizmos for jet lag

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Dr Brian Goldman was just chatting today on the CBC Homestretch about a neat new way of resetting our jet lagged brains. I tried to find a specific CBC blog post relating to this. The segment can be restreamed from – he was speaking at 1555 on 8Feb2016 on CBC Radio One. But there did not seem to be a more direct link.

I did find this, which relates to the same technique:

Confusingly, this is Dr Neil Goldman – no relation, I believe. It is expected that it will be about a year before these devices are available but it looks very promising.

A different kind of dope?

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Being liberal with the current theme of dopes, after this morning’s post about narcotic drugs. We’ve been used to drug and cheating scandals in cycling. Who still wears a yellow wristband?


Image linked from

But this week saw the first case of technical doping: Engadget reports on ‘Cycling officials find motor hidden inside competition bike‘, where a hidden motor has been allegedly found inside a bicycle frame. “It wasn’t my bike,” claims the rider, but she must think us a bunch of dopes if she is pedalling that story. (It’s the weekend – the humor is awful.)

Prescribing for Pain

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There have been several recent topics to get us thinking more about this. Without trying to be morbid in the wake of yesterday’s post about Physician Assisted Dying on our sister site, the high number of recent deaths from fentanyl makes us think about whole different kind of PAD.

iMedicalApps just posted a note about an app called ‘Safe Opioids‘, (scan the QR code to find the app) along with comments and review, along with commentary about some other apps and calculators that are out there. I do agree with their comments that there is a quite a bit of variability with the narcotic equivalent calculators – worth doing a comparison run to see what equivalent doses you get.

It also reminded me of something that I came across on Bandolier a few years ago. The Oxford League of analgesics in acute pain – a nicely done table. It does rank quite a few -coxibs that we don’t have here but is useful nonetheless, especially for educating your learners.

You’ll note that the narcotics don’t fare particularly well. Doctors from other countries remark upon our high use of codeine in Canada. Maybe we are training our patients’ nociceptors to expect a certain hit. CaMH and the College of Physicians and Surgeons of Alberta do a very practical course on Opioid Dependence Treatment, facilitated by our CME office here at the University of Calgary. Lots of case discussions, based on our OpenLabyrinth virtual patient platform.

Cabin Fever 2016 at Kananaskis

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Come on out to Kananaskis this weekend for Cabin Fever 2016. This is our annual faculty development event for rural physician teachers, hosted by Distributed Learning & Rural Initiatives (DLRI) at the Cumming School of Medicine.

Starting tonight, this is one of the most vibrant FacDev events in Medical Education in Canada, with lots of great presenters, all with a rural focus. Families, students, residents and even a few preceptors will all be there to learn and have fun.

Follow the Twitter hashtag #cfvr2016 for the latest updates.

CURIOS at Cabin Fever 2016

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Coming to Cabin Fever (#cfvr2016) in Kananaskis this year? Hope to see you all in a couple of day’s time. This annual faculty development event for rural Alberta clinical teachers is hosted by Distributed Learning & Rural Initiatives (DLRI) at the University of Calgary.

One of the things that we hope to show off is part of our CURIOS tools – the Video Mashup tool. Check out a few week examples here…

Come by the PLP booth and check it out.