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October 25, 2019

Are the stethoscope's days numbered?

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    The stethoscope is a stalwart in medical technology and a symbol of the medical profession, but recent advances in artificial intelligence (AI) and smartphone apps could mean the device's days are coming to an end, Lindsey Tanner reports for the Associated Press.

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    The end of the stethoscope?

    The stethoscope has been around for 200 years, Tanner reports, and in that time, the device has become ubiquitous among doctors. On top of that, it also holds symbolic meaning, as practically all medical schools in the United States give stethoscopes to incoming students to signify the start of their careers, Tanner reports.

    But over the past decade, medical technology companies have released devices that could render the humble stethoscope obsolete, some experts say. Today, companies offer ultrasound scanners the size of TV remotes and digital stethoscopes that can link with smartphone apps to create moving pictures and readouts of a patient's heart, Tanner reports.

    For example, medical imaging company Butterfly Network last year released the Butterfly iQ device, a transportable single probe, whole body imaging device that will soon include an update utilizing AI to help providers position the probe and interpret its images.

    Similarly, Eko, a California-based maker of smart stethoscopes, is developing AI algorithms for its stethoscopes using the recordings of thousands of heartbeats to inform the doctor whether the heart sounds normal or if it detects murmurs, Tanner reports.

    Proponents of these devices say they're as easy to use as a stethoscope and provide doctors with more data. Eric Topol, a cardiologist, said "There's no reason you would listen to sounds when you can see everything." In fact, Topol said he believes the stethoscope is obsolete and nothing more than a pair of "rubber tubes." He added that the stethoscope "was OK for 200 years," but "we need to go beyond that. We can do better."

    James Thomas, a cardiologist at Northwestern Medicine, said with medical advances over the past few decades, "the old stethoscope is kind of falling on hard times in terms of rigorous training. Some recent studies have shown that graduates in internal medicine and emergency medicine may miss as many of half of murmurs using a stethoscope."

    Why some doctors believe the stethoscope will live on

    However, that doesn't mean stethoscope training has gone completely by the wayside in medical schools, Tanner reports.

    Paul Wallach, executive associate dean at Indiana University, said the new devices advance "our ability to take [a] peek under the skin into the body," but added that he doesn't believe the stethoscope is dead. He believes the next generation of doctors will wear "a stethoscope around the neck and an ultrasound in the pocket."

    Dave Drelicharz, a pediatrician in Chicago, said he understands the attraction of newer technology, but until those devices become more affordable, the stethoscope "is still your best tool." Once you learn how to use it, it "becomes second nature," he said. "During my work hours in my office, if I don't have it around my shoulder, it's as though I was feeling almost naked," Drelicharz added (Tanner, Associated Press, 10/23).

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