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iStethoscope App Does Not Replace A Doctor’s Stethoscope

An article in The Guardian, the popular British newspaper, on an iPhone medical app that attempts to replicate the stethoscope starts out as:

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.

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.

It’s obvious to those intimate with medicine that “3 million doctors” using this app was a ridiculous number. Unfortunately, it took The Guardian one full week to realize this egregious error — they meant to say “3 million overall downloads” –- but by then the news had been disseminated to hundreds of news websites, blogs, and potentially millions of readers. Leading readers to infer that with “3 million physician downloads” the medical community had signed off on the app.

The story went on to say:

Experts say the software, a major advance in medical technology, has saved lives and enabled doctors in remote areas to access specialist expertise.

Lets be clear what this application does.

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.

I tried using the app on a range of people — from thin to not so thin, and I had great difficulty in even finding the correct orientation to place the phone. When I was actually able to pick up heartbeat like sounds, there was a great deal of artifact and muffled noise. This type of experience is echoed by the one to two star ratings of the app in the App Store. This cumbersome experience also shows why it’s relatively useless in a public health setting –- contrary to what The Guardian story leads readers to believe.

We covered iStethoscope almost a year ago on iMedicalApps. At the time we thought it was a good idea and we still believe this. The idea is innovative, and it could be described as a “cool” app. But not something that would ever replace a stethoscope.

It’s obvious Mobile health is still in it’s infancy. As we have chronicled in the past, mobile technology has huge implications towards improving medical care and patient outcomes. Due to mobile healths relative infancy, inaccurate stories perpetuated by reputed sources — in this case The Guardian — can spread in a viral manner with little recourse.

For mobile health to truly take hold evidence based studies are required, such as the George Washington Emergency Medicine story we covered recently.

It’s up to physicians and health care professionals to make sure the public is aware of not only the potential of mobile health, but also the limitations –- in an evidence-based and accurate manner.

*This blog post was originally published at iMedicalApps*


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