Littmann Cardiology IIIe of the HeartBuds, an electronic smartphone listening device, compared to FDA approved Class I and Class II stethoscopes

Abstract

Background: Auscultation with stethoscopes is essential to the physical exam. However, the stethoscope has not appreciably changed since Leared and Cammann developed the first binaural stethoscopes in the mid 1800s. Because of technological advances, it is possible to use smartphone technology to auscultate patients, and the HeartBuds, a listening device that integrates with an iPhone app to achieve this purpose. The purpose of this study was to compare HeartBuds' acoustic superiority over the FDA approved class I blue disposable stethoscopes, which are commonly used in practice to reduce hospital infection rates, and demonstrate equivalence to the gold standard FDA class I analog stethoscope, the Littmann Cardiology III, and the FDA class II digital stethoscope, the Littmann Electronic 3200. Methods: 50 patients were auscultated with the above-mentioned stethoscopes. Two examiners independently used these stethoscopes and rated their acoustic quality in addition to filling out surveys documenting body sounds heard. Results: The disposable stethoscope was significantly worse at identifying cardiac murmurs (p<0.002), and performed poorly when auscultating for carotid bruits (p<0.058). The HeartBuds was equivalent to its more commonly used counterparts, the Littmann Cardiology III and the Littmann Electronic 3200. Examiners also found it to be of comparable acoustic quality to these models. Conclusion: HeartBuds is a smartphone compatible listening device that was superior in examining cardiovascular sounds to approved FDA Class I disposable stethoscopes, and equivalent to FDA approved class I and class II Littmann stethoscopes. Considering HeartBuds equivalence to more expensive stethoscopes while costing much less, the HeartBuds can potentially reduce infection rates without sacrificing quality. This can be achieved all while reducing healthcare costs, which begs the question whether healthcare providers should rethink using the device they have grown used to hanging around their necks.