It's gotten to the point of almost corny when you hear the familiar phrase "there's an app for that." Whether used for GPS or as an e-reader, a camera or a video editor, it seems our smartphones are getting smarter every day. They save our lives, as a man trapped in Haitian rubble discovered earlier this year. And, they're becoming medical devices too.
Peter Bentley, we learn via Great Britain's Telegraph newspaper, has created an app, iStethoscope, that uses the iPhone's microphone to listen to your heart. Simply press the microphone just under your left nipple and be sure to use a pair of high quality earphones. (Bentley's instructions quite specifically dog on Apple's low quality white headphones -- and for good reason.)
Image Source: The article author's chest
According to the Telegraph article in question, "millions of doctors across the world" are downloading the app, at a rate of about 500 per day. The app comes in both a free and professional version ($0.99 in the States). We tried out the free version and were surprised to hear our heart so well. There are a few differing settings to filter the levels of background noise, though we never noticed the difference between them. Users can also playback the last eight seconds of their heart on a phonocardiograph with spectrogram showing off their heartbeats.
While the app in question seems like a fun device and would be handy to have around in an emergency, it just seems unlikely to us that millions of doctors are going to want to press their iPhones against the chests of random patients then later hold the same phone up to their faces. Combined with a good quality microphone/headphone combination, however, this app could certainly take off.
JJR512
August 31, 2010 at 10:27pm
1. There doesn't seem to be a free version in the US iTunes Store. The link in the article for the free version leads to a message in iTunes saying that it doesn't exist in the US store.
2. For the Pro version, there are more 1-star reviews than there are for all other star levels combined.
I was interested in trying the free version, but with its current reviews, I'm not going to bother trying the paid version. Pity, too; it seemed like a good concept, too bad it's apparently been so poorly executed.
JJR512
August 31, 2010 at 10:21pm
J Keirn-Swanson, you have some good points, but hospitals aren't interested in getting iPhones or iPod Touches (and now, iPads, too) just for this. There are a lot of medical apps available. Physicians can get sent real-time medical date no matter where they are. There are many reasons for hospitals to consider bringing in devices like this.
Who knows, this iStethoscope app and the iPhone might be the first step towards making Star Trek's medical tricorder a reality!
J Keirn-Swanson
August 31, 2010 at 6:41pm
the best possible use I can imagine this for is for physicians or people who are caregivers to those will illnesses etc. You're out and about, someone begins to complain of ill feeling, their symptoms are sufficient to warrant your concern, but you don't have you stethoscope with you. That's all right, you've got headphones and your iPhone on hand. Sure, you'll want to give it a good sanitizing after the fact, but it might just help save a life.
It may also play a role in medical students practicing.
I really don't see hospitals stocking up on iPhones or even iPod touches (or Nano touches should tomorrow's event reveal those) for the sake of having a stethoscope that also plays cat videos, but I can see its utility. And for free, it'd be worth having.
JJR512
August 31, 2010 at 4:53pm
The previous commenter has laid out three reasons why this app will not replace a stethoscope. Here's my rebuttal.
1. Your entire Point #1 describes why this won't be a good interpretation tool. This article does not describe the iPhone/iStethoscope combo as an interpretation tool, it describes it as an auscultation tool. Only the means of auscultation (what you stick in your ear, what you place on the patient's chest) is changed by this combo. This article does not say this combo is intended to be a replacement for the human ear and brain, just for the stethoscope.
2. Your Point #2 is the only good one you made. This problem, though, can possibly be solved with a microphone/headphone combination, as mentioned in the article.
3. Again you talk about diagnosis. I see no mention in this article that this iPhone/iStethoscope combination is intended to be a diagnostic tool, or that it's meant to replace human judgement. ALL it's supposed to do is change the means by which the sound gets into our ears so our brains can interpret it. You say it matters where on the body you hear a particular sound? Well move the microphone around, just as you do with a stethoscope bell. You seem to imply that this is going to take a long time ("by the time you're done doing that..."), but I don't see why it would take any longer to move the iPhone (or an attached microphone) around than a stethoscope bell.
Overall, I think what you failed to realize, dtreese, is that this app essentially turns your iPhone into an electronic stethoscope, like those made by Littmann or ADC. It doesn't really do more, nor is it intended to be more, than that. For someone that already has an iPhone, you can get an electronic stethoscope with this app for either free or 99¢, plus possibly the cost of a microphone/headset, or you could buy an ADC for about $200 or a Littmann for even more.
One final note: For anyone who needs a stethoscope, if you choose to make your primary stethoscope an electronic one—whether a real electronic one or this app/iPhone combo—I would advocate always having a standard acoustic stethoscope as a backup.
dtreese
August 31, 2010 at 12:21pm
As a physician, I can tell you that this is a novelty but unlikely to be a replacement for the real thing for several reasons:
1. We already have computers that automatically interpret EKG's, and they simply aren't a replacement for a human eye. Part of it can be over-interpreting a pattern, but part of it is the computer's inability to incorporate history and physical exam into diagnosis.
2. There's a hygiene issue as noted above. It's one thing to clean my stethoscope every time I leave a room, but it's quite another to sanitize my phone that much. At the risk of sounding insensitive, there are just some people (i.e. everyone) whose chest sweat I don't want to rub on the side of my face, even if it has been disinfected by alcohol.
3. There's more than just the sound of the heart to diagnosis of a murmur or aberrant heart sound. It matters where on the body the murmur is loudest. Sure, you could set the iphone to each location and compare sounds. Then again, by the time you're done doing that, you could have finished the exam. When you have performance-based compensation, faster is better.
The app is nifty, and it has potential to be a good learning tool, but a replacement for the steth? Not so much.
The_Quintessent...
August 31, 2010 at 10:52am
"…it just seems unlikely to us that millions of doctors are going to want to press their iPhones against the chests of random patients then later hold the same phone up to their faces."
They can use a screen protector!
