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Fourteen patients attending the rehabilitation programme agreed to participate and we recorded the lung sounds that same evening. We got permission to hold a presentation about lung sounds and at the end of the presentation we invited the patients to be part of our research project as subjects. We took contact with a rehabilitation programme in northern Norway for patients with heart and lung-related diseases (lung cancer, chronic obstructive pulmonary disease, heart failure, and so on). In order to obtain material to classify, we recruited a convenience sample of 20 subjects aged 40 years or older. In August to October 2014 we conducted a cross-sectional study to explore agreement in the classification of lung sounds. The aim of the present study was to describe the interobserver agreement among an international sample of raters, including general practitioners (GP), pulmonologists and medical students, when classifying lung sounds in adults aged 40 years or older using audio recordings with display of spectrograms. However, we still do not know the reliability of such classifications. Recording and visual display of lung sounds may be applied in large samples and classifications of the sounds may be repeated.
Lung sounds software#
15–17 Recorded sounds may be presented with a visual display, and creating spectrograms of lung sounds is already an option in the software of electronic stethoscopes. Studies of interobserver agreement using lung sound recordings, rather than traditional auscultation, may be a good alternative. New methods are needed for clinical research in this area to generate evidence-based knowledge about the role that lung sounds have in a modern clinical setting. 1 11–14 In addition, the use of such methods would be difficult to implement in large epidemiological studies due to logistical challenges.
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Clinicians working in the same hospital department have rated the sounds in these studies making the sample homogeneous and applicability of the results may be questioned. However, most of these agreement measures were based on clinicians sequentially listening to patients with a stethoscope. 10–14 Lower agreement levels have also been found. 9 Similar results have been found in other studies. 6–8 In a scale from 0 to 1, a study by Spiteri et al found a kappa of κ=0.41 for crackles and κ=0.51 for wheezes when clinicians classified lung sounds. 1–5 However, the diagnostic value of chest auscultation may be questioned due to variability in recognising lung sounds. Adventitious lung sounds, such as wheezes and crackles, are helpful in the diagnosis of several lung and heart-related conditions. Lung auscultation is an old and well-known technique in clinical medicine.
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8 Department of Pediatrics and Child Health, University of Manitoba College of Medicine, Winnipeg, Manitoba, Canadaĭr Juan Carlos Aviles-Solis juan.c.solisuit.no.7 Unit of Clinical Physiology, HUS Medical Imaging Center, Helsinki University Hospital and University of Helsinki, Helsinki, Finland.6 Lab 3R–Respiratory Research and Rehabilitation Laboratory, School of Health Sciences (ESSUA) and Institute for Research in Biomedicine (iBiMED), University of Aveiro, Aveiro, Portugal.5 Department of Family Medicine, Northern State Medical University (NSMU), Arkhangelsk, Russia.4 Department of Family Medicine, CAPHRI Care and Public Health Research Institute, Maastricht University, Maastricht, The Netherlands.3 Department of Primary Care and Public Health, Cardiff University, Cardiff, UK.2 Department of Methodology and Statistics, University of Maastricht, Maastricht, The Netherlands.1 General Practice Research Unit, Department of Community Medicine, UiT The Arctic University of Norway, Tromsø, Norway.I think breath sounds are the kind of thing we will just have to get experience with. Honestly, I don't think I would have known if the sounds were reduced bilaterally since I could hear something on the reduced side, just not as loud. When I placed my stethoscope on the left side, however, the breath sounds were MUCH louder. When I listened on that side, I could hear breath sounds. I had a 2 year old boy with pneumonia and right pleural effusion - basically, a big wad of gunk in his right lower lobe.
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At one of my nursing school clinicals, I had an experience with diminished lung sounds and it was very obvious, but only when I listened on both sides. I am a new RN - I start my first job in 2 weeks. Can someone explain to me what diminished lungs are and what is the significance of this? Everyone I ask either doesn't know or they just say it means you don't hear the usual clear swooshing in and out (probably not a good way to put it).