Evidence map›Paper›PMID 32220901›Full record

ArticleBMJ open respiratory research2020

Influence of observer preferences and auscultatory skill on the choice of terms to describe lung sounds: a survey of staff physicians, residents and medical students.

Abraham Bohadana, Hava Azulai, Amir Jarjoui, George Kalak, Gabriel Izbicki

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Article in BMJ open respiratory research, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 8 papers.

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0cells of the map it votes in
8citing papers in PubMed
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1 · What the graph read from it

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2 · The registry

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3 · Its place in the literature

Who cites it

8 citing papers in PubMed.

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4 · The record

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5 · Who and what money

Authors and funding

5 authors.

Abraham BohadanaMedicine, Pulmonary Institute, Shaare Zedek Medical Center, and the Hebrew University Hadassah Medical School, Jerusalem, Israel abraham.bohadana@gmail.com.
Hava AzulaiPulmonary Institute, Shaare Zedek Medical Center, Jerusalem, Jerusalem, Israel.
Amir JarjouiPulmonary Institute, Shaare Zedek Medical Center, Jerusalem, Jerusalem, Israel.
George KalakPulmonary Institute, Shaare Zedek Medical Center, Jerusalem, Jerusalem, Israel.
Gabriel IzbickiPulmonary Institute, Shaare Zedek Medical Center, Jerusalem, Jerusalem, Israel.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

backgroundIn contrast with the technical progress of the stethoscope, lung sound terminology has remained confused, weakening the usefulness of auscultation. We examined how observer preferences regarding terminology and auscultatory skill influenced the choice of terms used to describe lung sounds.

methodsThirty-one staff physicians (SP), 65 residents (R) and 47 medical students (MS) spontaneously described the audio recordings of 5 lung sounds classified acoustically as: (1) normal breath sound; (2) wheezes; (3) crackles; (4) stridor and (5) pleural friction rub. A rating was considered correct if a correct term or synonym was used to describe it (term use ascribed to preference). The use of any incorrect terms was ascribed to deficient auscultatory skill.

resultsRates of correct sound identification were: (i) normal breath sound: SP=21.4%; R=11.6%; MS=17.1%; (ii) wheezes: SP=82.8%; R=85.2%; MS=86.4%; (iii) crackles: SP=63%; R=68.5%; MS=70.7%; (iv) stridor: SP=92.8%; R=90%; MS=72.1% and (v) pleural friction rub: SP=35.7%; R=6.2%; MS=3.2%. The 3 groups used 66 descriptive terms: 17 were ascribed to preferences regarding terminology, and 49 to deficient auscultatory skill. Three-group agreement on use of a term occurred on 107 occasions: 70 involved correct terms (65.4%) and 37 (34.6%) incorrect ones. Rate of use of recommended terms, rather than accepted synonyms, was 100% for the wheezes and the stridor, 55% for the normal breath sound, 22% for the crackles and 14% for the pleural friction rub.

conclusionsThe observers' ability to describe lung sounds was high for the wheezes and the stridor, fair for the crackles and poor for the normal breath sound and the pleural friction rub. Lack of auscultatory skill largely surpassed observer preference as a factor determining the choice of terminology. Wide dissemination of educational programs on lung auscultation (eg, self-learning via computer-assisted learning tools) is urgently needed to promote use of standardised lung sound terminology.

Indexed as

AuscultationClinical CompetenceLanguageAdultHumansInternship and ResidencyIsraelMiddle AgedPhysiciansRespiratory SoundsStudents, MedicalSurveys and QuestionnairesYoung Adultnot applicable

Identifiers

PMID32220901
PMCPMC7173982

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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.