推进听诊教育:将信号可视化作为加强病理性呼吸音检测的新工具

Anna Pastusiak, Honorata Hafke-Dys, J. Kocinski, Krzysztof Szarzynski, Kamil Janeczek
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摘要

导言听诊仍是诊断各种呼吸系统疾病的关键方法。为了增强其临床意义,我们必须不断加深对肺部声学的理解,同时改进听诊记录和分析方法。 材料和方法:我们研究了听诊信号的双模式呈现(声音和视觉线索感知)如何影响病理呼吸音检测的主观效果,这是开发新听诊工具的关键一步。小儿呼吸音的记录以三种不同的形式呈现--仅音频、仅视觉呈现(频谱图)或视听(两者同时呈现)。计算出 F1 分数、灵敏度和特异性参数,并与黄金标准(GS)进行比较。在检测实验之后,参与者填写了一份调查问卷,以主观评估程序中频谱图的可用性。 结果显示超过 60% 的受访者认为频谱图重要(40.8%)或非常重要(21.1%)。此外,11.3% 的参与者认为这种新的听诊结果呈现形式比仅评估声音更有用。从统计学角度看,增加视觉信息并没有明显改变对声音本身的评价,但这一可观察到的趋势意味着,用视觉效果增强音频记录可以提高检测性能。医生和学生的灵敏度分别提高了 4 个百分点和 2 个百分点,即使没有经过专门的视觉训练,这一点也是显而易见的。 结论:我们的研究结果表明,尽管是基于观察到的趋势和调查反馈,但将频谱图与传统听觉评估相结合,为提高医学教育的精确度和质量,以及加强诊断和监测过程提供了一个前景广阔的途径。
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Advancing Auscultation Education: Signals Visualization as a Novel Tool for Enhancing Pathological Respiratory Sounds Detection
Introduction: Auscultation remains a pivotal diagnostic modality for various respiratory pathologies. To augment its clinical relevance, the continuous expansion of our understanding of pulmonary acoustics, coupled with the advancement of auscultation recording and analysis methodologies, is imperative. Material and methods: We investigated how the bimodal presentation of auscultatory signals (sound and visual cue perception) influences the subjective efficacy of pathological respiratory sound detection, which is a critical step in the development of a new auscultation tool. Recordings of pediatric breath sounds were presented in three different forms - audio only, visual representation only (spectrogram) or audiovisual (both together). The F1-score, sensitivity and specificity parameters were calculated and compared to the gold standard (GS). Subsequent to the detection experiment, participants completed a survey to subjectively assess the usability of spectrograms in the procedure. Results: Over 60% of all responders ranked the spectrogram as important (40.8%) or very important (21.1%). Moreover, 11.3% of all participants found this new form of presentation of auscultation results to be more useful than the evaluation of sound only. The addition of visual information did not statistically significantly change the evaluation of the sounds themselves, an observable trend implies that enhancing audio recordings with visualizations can enhance detection performance. This is evident in the 4 p.p. and 2 p.p. sensitivity increments for physicians and students, respectively, even without specialized visual training. Conclusions: Our research findings indicate that the integration of spectrograms with conventional auditory assessment, albeit based on observed trends and survey responses, presents a promising avenue for improving the precision and quality of medical education, as well as enhancing diagnosis and monitoring processes.
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