Heart Diseases Clinical Trial
Official title:
Comparison of Stethee® to the Conventional Stethoscope for Auscultation of Simulated Heart Sounds: A Randomised, Crossover, Non-Inferiority Trial (STELIT)
The objective of this study is to compare the relative capability of Stethee® (new wireless digital stethoscope) and 3M™ Littmann® Classic III™ (conventional stethoscope) in the identification of manikin-simulated heart sounds by medical doctors. A randomised, non-blinded, two-period crossover, non-inferiority design will be used to compare the acoustic performance of the two stethoscopes. We aim to determine if Stethee® is as effective as 3M™ Littmann® Classic III™ for auscultation of simulated heart sounds, and whether Stethee® could be recommended for use in clinical practice based on a non-inferior comparison with 3M™ Littmann® Classic III™.
This is a randomised, non-blinded, two-period crossover, non-inferiority study. Stethee®, a
new wireless digital stethoscope, is designed to minimise ambient noise associated with
electronic stethoscopes. To date, its acoustic capability in comparison to the conventional
stethoscope in the auscultation of heart sounds is not known. Therefore, it is important that
Stethee®'s capability as a stethoscope with sound amplification be evaluated alongside the
conventional stethoscope prior to its use in the clinical setting. As acoustic performance is
the primary endpoint, a non-inferiority design is proposed to enable the comparison of the
mutual functionalities of the two stethoscopes. The rationale for a non-inferiority design is
that: (a) electronic stethoscopes have shown a marginal benefit over conventional
stethoscopes in terms of acoustic performance; (b) electronic stethoscopes have several
functional advantages over conventional stethoscopes: the ability to analyse heart sounds and
record heart sounds, the availability of a database for storage of heart sounds for remote
analysis; and (c) electronic stethoscopes were rated better than conventional stethoscopes in
terms of the overall quality of auscultation.
The relative capability of Stethee® is compared to that of 3M™ Littmann® Classic III™ by the
identification of heart sounds simulated by a manikin, which functions as a surrogate
patient. A random sample of non-specialist doctors stratified by health centres in Perak,
Malaysia, who meet eligibility criteria and provide written consent to participate, will be
randomised to initial testing with Stethee® or 3M™ Littmann® Classic III™ to perform cardiac
auscultation on a manikin and identify a set of 10 heart sounds. After a 10-minute break,
they will repeat the auscultation of the same 10 simulated heart sounds but played in a
different sequence with the alternate stethoscope. Following the completion of both tests,
the doctors will be asked to complete a questionnaire that asks about their preference for
either Stethee® or 3M™ Littmann® Classic III™ with respect to ease of use, audio clarity, and
diagnostic accuracy. At the end of the study, answer sheets and preference questionnaires
will be collected for grading and analysis.
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