The Cardiac Auscultatory Recording Database (CARD): an Internet-based Software Program and Digital Heart Sound Recording Database for Teaching and Study of Cardiac Auscultation
Current medical training techniques rely on significant patient contact, resulting in high training costs and often not the expected outcomes. In a 1997 study published in The Journal of American Medical Association, researchers found that on average, internal medicine and family practice residents (all four years) recognized only 20% of the common cardiac problems that could be diagnosed using a stethoscope; the cardiac auscultation skills of 198 internal medicine and 255 family practice residents were tested. In follow-up to this study, the researchers tested a small group of cardiologists (n=10); the specialists' results were significantly more accurate than the non-specialist residents' results on a majority of the tests. The recent shift toward managed care and ambulatory-based medicine has focused attention on the role of the generalist in providing competent and cost-effective care. APL's auscultation technology and database have product potential in three broad markets: medical education, cardiopulmonary medical device and telemedicine.
This invention is a screening tool for heart and lung aliments. Advanced signal processing techniques have been applied to heart and lungs sounds as an aid to diagnoses. A database containing patient demographics, relevant health information, physical exam results, ECG traces, echocardiograph diagnoses, and auscultatory findings obtained with a traditional stethoscope are all linked together with digitized recordings of patient data. Included are recordings from five (5) standard auscultatory areas. The initial prototype device provides two acoustic channels and one ECG channel which can be stored, digitized and processed on a laptop computer; noise cancellation using adaptive filtration techniques are developed enabling use in noisy environments. The laptop computer is also used to create multiple time/frequency analyses and display screens. The Cardiac Auscultatory Recording Database (CARD) was also developed. Developed using the Microsoft Access relational database program, CARD is available online through the World Wide Web. CARD contains digitized heart sound recordings collected from patients at the Pediatric Cardiology Echocardiography Laboratory at the Johns Hopkins Outpatient Center. To date, the database contains over 2500 individual recordings from over 350 patients, representing 300 unique heart murmurs. At last one third of the patients have no detectable heart disease by echocardiogram, with roughly 25% of the “normal” cases having at le4ast one innocent murmur. Among the other patients with abnormal echocardiograms, a wide range of diagnoses are represented, including many common congenital lesions.
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