The accuracy of lung auscultation in the practice of physicians and medical students
The accuracy of lung auscultation in the practice of physicians and medical students
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DOI：
10.1371/journal.pone.0220606
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发表时间：
2019-08-12
期刊：
影响因子：
3.7
通讯作者：
Biniakowski, Adam
中科院分区：
文献类型：
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作者：
Hafke-Dys, Honorata;Breborowicz, Anna;Biniakowski, Adam
背景听诊是病人在全科医生办公室接受的第一批检查之一，特别是与呼吸系统疾病有关的检查。然而，这是一个高度主观的过程，并取决于医生的能力来解释的声音，确定由他/她的psychoacousticcharacteristics.Here，我们提出了一个横截面评估的技能，医生的不同专业和医学生在儿童呼吸sounds.Methods和findings 185参与者的分类，代表不同的医学专业参加了实验。实验包括24个呼吸系统听诊音。参与者的任务是倾听，并将声音与特定声音类别的描述相匹配。结果显示，呼吸音的识别和描述都存在困难。在正确答案的数量方面，肺病专家组的表现明显优于其他组。我们还发现，性能显着改善时，类似的声音类被分组到一起更广泛，更一般的class.ConclusionsThese结果证实，模糊的识别和解释的声音听诊是一个通用的问题，不应被忽视，因为它可能会导致不准确的诊断和治疗。我们的研究结果进一步支持了已经广泛承认的需要标准化的听诊声音的命名（根据欧洲呼吸学会，国际肺音协会和美国胸科学会）。特别是，我们的研究结果指向重要的教育挑战，在理论（命名）和实践（培训）。
BackgroundAuscultation is one of the first examinations that a patient is subjected to in a GP's office, especially in relation to diseases of the respiratory system. However it is a highly subjective process and depends on the physician's ability to interpret the sounds as determined by his/her psychoacoustical characteristics.Here, we present a cross-sectional assessment of the skills of physicians of different specializations and medical students in the classification of respiratory sounds in children.Methods and findings185 participants representing different medical specializations took part in the experiment. The experiment comprised 24 respiratory system auscultation sounds. The participants were tasked with listening to, and matching the sounds with provided descriptions of specific sound classes. The results revealed difficulties in both the recognition and description of respiratory sounds. The pulmonologist group was found to perform significantly better than other groups in terms of number of correct answers. We also found that performance significantly improved when similar sound classes were grouped together into wider, more general classes.ConclusionsThese results confirm that ambiguous identification and interpretation of sounds in auscultation is a generic issue which should not be neglected as it can potentially lead to inaccurate diagnosis and mistreatment. Our results lend further support to the already widespread acknowledgment of the need to standardize the nomenclature of auscultation sounds (according to European Respiratory Society, International Lung Sounds Association and American Thoracic Society). In particular, our findings point towards important educational challenges in both theory (nomenclature) and practice (training).