![]() The stethoscope only produced noise when its diaphragm was in contact with the body ( Taylor and Fothergill, 1956). It overcame the poor sound quality of previous electronic stethoscopes and had a good environmental noise reduction effect. In 1956, Airsonic Limited (London) produced a new electronic stethoscope that included a miniature battery-operated amplifier, a contact microphone, and conventional ear-pieces. Given these defects, the electronic stethoscope emerged ( Tavel, 2006 Bank et al., 2016 Rennoll et al., 2021). However, several limitations of the acoustic stethoscope are evident, such as interference from environmental noise, low volume, and the lack of storage and playback functions. ![]() With its low price and ease of use, the acoustic stethoscope is still the most common auscultation tool despite 200 years of evolution and development ( Vyshedskiy et al., 2009 Bank et al., 2016). Because the sound heard by direct auscultation is weak and inconvenient to operate, indirect auscultation has gradually replaced direct auscultation since the invention of acoustic stethoscope ( Sarkar et al., 2015). Direct auscultation attaches the ear directly to the body wall of the examined person, while indirect auscultation uses a stethoscope. Auscultation can be classified as direct or indirect. The fake crackle was generated when the diaphragm of the electronic stethoscope left the skin slightly but not completely.Ĭonclusion: Fake crackles are most likely to be heard when using an electronic stethoscope to auscultate bilateral lower lungs, and the frequency of a fake crackle is close to that of a crackle, likely affecting the clinician’s diagnosis.Īuscultation is a standard physical examination method used by physicians and is widely accepted by doctors and patients because of its simplicity, repeatability, and non-invasiveness. The spectral analysis revealed that the frequency range of fake crackles was approximately 250–1950 Hz. Furthermore, more than 90% of fake crackles appeared in the inspiratory phase, similar to fine crackles, significantly interfering with clinical diagnosis. There were significant differences between lower lung and larynx ( p < 0.001), lower lung and upper lung ( p = 0.005), lower lung and middle lung ( p = 0.005), and lower lung and infrascapular region ( p = 0.027). Fake crackles were found predominantly in the lower lung. Results: A total of 500 audio recordings were included in the study, with 61 fake crackle audio recordings. Finally, the fake crackle was artificially regenerated to explore its causes. High-pass and low-pass filters were used to detect the frequency distribution of the fake crackles. The doctor identified the fake crackles and analyzed their frequency spectrum. A 30-s audio recording was recorded from each of the nine locations of the larynx and lungs of each participant with a 3M Littmann 3200 electronic stethoscope, and the audio was output in diaphragm mode and auscultated by the clinician. Methods: A total of 56 participants with healthy lungs (no underlying pulmonary disease, no recent respiratory symptoms, and no adventitious lung sound, as confirmed by an acoustic stethoscope) were enrolled in this study. This paper will discuss the causes, characteristics, and occurrence rules of the fake crackle and establish a reference for improving the reliability of the electronic stethoscope in lung auscultation. However, they generate noise similar to a crackle during use, significantly interfering with clinical diagnosis. 2Faculty of Medicine, Macau University of Science and Technology, Macau, Chinaīackground: Electronic stethoscopes are widely used for cardiopulmonary auscultation their audio recordings are used for the intelligent recognition of cardiopulmonary sounds.1National Center for Respiratory Medicine, State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China. ![]() Peitao Ye 1 † Qiasheng Li 1 † Wenhua Jian 1 Shuyi Liu 1 Lunfang Tan 1 Wenya Chen 1 Dongying Zhang 1,2* Jinping Zheng 1*
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