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Minerva Pediatrica 2019 June;71(3):221-8

DOI: 10.23736/S0026-4946.18.04974-5

Copyright © 2018 EDIZIONI MINERVA MEDICA

language: English

Novel algorithm to screen for heart murmurs using computer-aided auscultation in neonates: a prospective single center pilot observational study

Renata GRGIC-MUSTAFIC 1, 2, Nariae BAIK-SCHNEDITZ 1, 2, Bernhard SCHWABERGER 1, 2, Lukas MILEDER 1, 2, 3, Corinna BINDER-HESCHL 1, 2, Jasmin PANSY 1, 2, Martin KOESTENBERGER 3, Berndt URLESBERGER 1, 2, Alexander AVIAN 4, Gerhard PICHLER 1

1 Research Unit for Neonatal Micro- and Macrocirculation, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; 2 Division of Neonatology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; 3 Division of Pediatric Cardiology, Department of Pediatrics and Adolescent Medicine, Medical University of Graz, Graz, Austria; 4 Institute for Medical Informatics, Statistics and Documentation, Medical University of Graz, Graz, Austria



BACKGROUND: Automated detection of heart murmurs with computer-aided auscultation is not yet in clinical routine use. Aim of this study was to test sensitivity and specificity of a novel prototype algorithm in automated detection of heart murmurs from digitally recorded phonocardiograms in neonates admitted at the Neonatal Intensive Care Unit.
METHODS: In a prospective pilot observational study from November 2012 to December 2013 auscultations by pediatricians and computer aided auscultation were performed within 12 hours of neonatal echocardiography. Echocardiography was defined as pathological when resulting in any clinical consequences or causing murmur. Phonocardiograms and auscultation were defined as pathological if a murmur was detected. Phonocardiograms were analyzed offline with a novel algorithm prototype (CSD Labs, Graz, Austria) for detection of murmurs in neonates in a first run and with an optimized algorithm in a second run and were compared with echocardiography. Sensitivity and specificity of auscultation by pediatrician and computer aided auscultation were analyzed.
RESULTS: Thirty-six neonates (gestational age: 36±3 weeks) were included. Twenty-three (64%) neonates had pathological or murmur causing findings in echocardiography (positive echocardiography). Sensitivity and specificity of auscultation by pediatrician were 17% and 100%, respectively. In comparison to auscultation by pediatrician sensitivity of first run and second run were significantly higher with 70% and 83%, respectively. Specificity of first run and second run were 77% and 85%, respectively.
CONCLUSIONS: Phonocardiogram analysis using the novel algorithm prototype had a higher sensitivity than auscultation by pediatrician in detecting positive echocardiography findings in neonates.


KEY WORDS: Auscultation; Heart murmurs; Infant, newborn; Phonocardiography

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