An iPhone app isn’t “disappearing” stethoscopes

By: Brian Dolan | Sep 8, 2010        

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Topol: wireless health has killed the scethoscopeAn article published in the UK’s Guardian last week included an unfortunate error — just because it’s intended for physicians, doesn’t mean everyone who downloads a particular iPhone medical app is one:

“The stethoscope – medical icon, lifesaver and doctor’s best friend – is disappearing from hospitals across the world as physicians increasingly use their smartphones to monitor patients’ heartbeats,” The Guardian wrote. “More than 3 million doctors have downloaded a 59p application – invented by Peter Bentley, a researcher from University College London – which turns an Apple iPhone into a stethoscope.”

The Guardian has since issued this correction: “We reported below that more than 3 million doctors had downloaded an application, invented by a University College London researcher, that allows an Apple iPhone to be used as a stethoscope. What we should have said was that according to the inventor, Peter Bentley, 3 million people in general downloaded this app. (Three million doctors would have been a substantial proportion of the world’s stock of same.)”

iMedicalApps, which first reported on the Guardian’s correction this morning, sums up the iStethoscope app’s functionality succinctly: “You take the bottom part of your iPhone, where the microphone is, and place it on the key auscultation points on your chest – Aortic, Pulmonic, Tricupsid, and Mitral. The app then enhances the sound that the microphone hears on your iPhone, and then you can supposedly use the sounds to detect heart pathologies. Basically – it’s a glorified microphone – not something you would want to detect life threatening cardiac pathologies with. On top of this, you have to place the microphone in exactly the correct place, and then assume your patient is thin and doesn’t have extra adipose tissue to distort the noise – not practical by any means.”

The Guardian article did do a worthwhile job of sketching out the general regulatory mood for wireless health devices in Europe though (our summary of that here).

I don’t think it’s a coincidence that the a dust up over mHealth hype started up again last week shortly after the Guardian posted the iStethoscope article. The idea that an iPhone app using the phone’s mic might be good enough to cause the “disappearance” of stethoscopes in hospitals across the world is ludicrous.

Another wireless health device will be responsbile for that, right? GE Healthcare’s handheld ultrasound device Vscan was already dubbed wireless health’s “stethoscope killer” at TEDMED last year — here’s MobiHealthNews’ report from that event.

For more on the Guardian goof, check out iMedicalApps’ thoughtful rebuke.

  • Matthew

    Now I am not a doctor, though I did study sports medicine and have had experience using stethoscopes, but I have by no means mastered the ability to hear and comprehend heart sounds.

    However, I don’t see why the iStethoscope cannot be the future of listening to heart sounds. Calling it a glorified microphone is not a bad thing. What is a current stethoscope….a glorified eardrum. It’s nothing but a tube and a membrane. Doesn’t the doctor have to put the drum of the stethoscope in the precise locations on the body to hear heart sounds? Why would it be any more difficult with a phone. Wouldn’t adipose tissue muffle the sounds coming through a traditional stethoscope as well? It seems that is always has been the doctors’ expertise and experience in hearing and acknowledging sounds that results in a proper diagnosis. Not the instrument used to hear it.

    I’m not saying doctor’s should be using the iStethoscope vs a traditional one, but depending on how accurate the iPhone can record the sounds, I don’t see why it would be any less trustworthy. It’s ultimately left to the doctors interpretation.

  • David Albert, MD

    I am a doctor and I have used many stethoscopes. My present unit (for the last 6 years) is an electronic one from 3M. It is magnificent. I have looked at the heart sound signal from an iPhone and it is BAD! This entire episode was filled with errors! I doubt 3MM people have downloaded the app, I know many docs with iPhones (lots of Cardiologists) and none have downloaded it. It is not sanitary (needs to be sanitized between patients) nor convenient .. and did I say it is a BAD stethoscope? Heart sounds have their principal energy between 25 and 250 Hz. That range is not strong for the iPhone mic– it was designed for voice in the 1-3khz range but will work much higher. The Guardian made mistakes and I hope they don’t end up angering the FDA and making the path for medical innovation around smartphones more difficult!

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