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Does the stethoscope die? High-tech rivals are a threat



Two centuries after its invention, the stethoscope – the very symbol of the medical profession – is facing an uncertain prognosis.

It is threatened by hand-held devices that also press against the breast but rely on ultrasonic technology, ie. applications for artificial intelligence and smartphones instead of doctors' ears to help detect leaks, noises, unusual rhythms and other problems in the heart, lungs and elsewhere. Some of these tools can give heartbeat images or create electrocardiogram charts.

Dr. Eric Topol, a world-renowned cardiologist, thinks the stethoscope is outdated, nothing more than a pair of rubber tubes.

"It's been 200 years," Topol said. But "we have to go beyond that. We can do better. ”

In a long tradition, almost every American medical school presents arriving students with a white coat and stethoscope to start their careers. This is more than symbolic ̵

1; stethoscope skills are still being taught, and doctors are required by doctors to obtain their licenses.

However, in the last decade, the technology industry has reduced the number of ultrasound scanners in TV-like devices. He has also created digital stethoscopes that can be paired with smartphones to create moving photos and readings.

Proponents say these devices are almost as easy to use as stethoscopes and allow doctors to monitor the body on the move and actually see things as permeable. valves. "There's no reason to hear sounds when you can see everything," Topol said.

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In many medical schools, it is the newer devices that really pump the hearts of students.

“Wow!” ″ Who! "That's great," Indiana University medical students exclaimed in recent class as they learned how to use a classmate's portable ultrasound device while looking at images of their heart for duplication on a tablet screen.

The iF Butterfly device, made by Guilford, Connecticut-based Butterfly Network Inc., was released last year. The update will include artificial intelligence to help users position the probe and interpret the images.

Students at the Indianapolis-based medical school, one of the largest in the country, study stethoscopic skills but also receive manual ultrasound training in a program launched last year by Dr. Paul Wallach, associate associate dean. He created a similar program five years ago at Georgia Medical College and predicts that within the next decade, manual ultrasound devices will become part of a routine physical examination similar to a reflex hammer.

Devices are advancing "our ability to peek under the skin in the body," he said. But Vlash added that unlike some of his colleagues, he was not ready to declare the stethoscope dead. He envisions the next generation of doctors wearing a "neck stethoscope and an ultrasound in his pocket." the same way.

The creation of Laennetz is a hollow trumpet almost a foot long that makes it easier to hear sounds from the heart and lungs than pressing the ear to the chest. Rubber tubes, headphones, and the often cold metal fastening that is placed against the breasts came later, helping to amplify the sounds.

When the stethoscope is pressed against the body, the sound waves make the diaphragm – the flat metal disk part of the device – and the underside of the bell shape vibrates. This channels the sound waves up through the tubes to the ears. Conventional stethoscopes typically cost under $ 200, compared to at least a few thousand dollars for some high-tech devices.

But the collection and interpretation of bodily sounds is subjective and requires a sensitive ear – and trained.

With the advancement of medicine and competing devices over the last few decades, "the old stethoscope is a kind of fall during difficult times in terms of rigorous workouts," says Dr. James Thomas, a cardiologist at Northwestern Medicine in Chicago. "Some recent studies have shown that graduates in internal medicine and emergency medicine can skip as much as half of the murmur using a stethoscope."

Northwestern is testing a new technology created by Eko, a manufacturer of intelligent Burley , California. stethoscopes. To improve the detection of heart murmurs, Eko develops artificial intelligence algorithms for its devices using thousands of pulses.

Denis Kalinan, a retired employee of Chicago with heart disease, is among the study participants. At 70, he had an abundance of stethoscopic exams, but said he had no nostalgia for the devices.

"If they can get better reading with the help of new technology, great," Kalinan said.

Chicago Pediatrician Dr. Dave Drehlichs has been in practice for just over a decade and knows the allure of newer devices. But until the price drops, the old port is "still your best tool," Drehlartz said. After learning how to use the stethoscope, he said that it "becomes second nature." almost naked. ”

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