{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,30]],"date-time":"2026-09-30T22:49:09Z","timestamp":1790808549626,"version":"4.1.0"},"reference-count":24,"publisher":"MDPI AG","issue":"19","license":[{"start":{"date-parts":[[2023,10,9]],"date-time":"2023-10-09T00:00:00Z","timestamp":1696809600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["Diagnostics"],"abstract":"<jats:p>Background. Technological advancement may bridge gaps between long-practiced medical competencies and modern technologies. Such a domain is the application of digital stethoscopes used for physical examination in telemedicine. This study aimed to validate the level of consensus among physicians regarding the interpretation of remote, digital auscultation of heart and lung sounds. Methods. Seven specialist physicians considered both the technical quality and clinical interpretation of auscultation findings of pre-recorded heart and lung sounds of patients hospitalized in their homes. TytoCareTM system was used as a remote, digital stethoscope. Results. In total, 140 sounds (70 heart and 70 lungs) were presented to seven specialists. The level of agreement was measured using Fleiss\u2019 Kappa (FK) variable. Agreement relating to heart sounds reached low-to-moderate consensus: the overall technical quality (FK = 0.199), rhythm regularity (FK = 0.328), presence of murmurs (FK = 0.469), appreciation of sounds as remote (FK = 0.011), and an overall diagnosis as normal or pathologic (FK = 0.304). The interpretation of some of the lung sounds reached a higher consensus: the overall technical quality (FK = 0.169), crepitus (FK = 0.514), wheezing (FK = 0.704), bronchial sounds (FK = 0.034), and an overall diagnosis as normal or pathological (FK = 0.386). Most Fleiss\u2019 Kappa values were in the range of \u201cfare consensus\u201d, while in the domains of diagnosing lung crepitus and wheezing, the values increased to the \u201csubstantial\u201d level. Conclusions. Bio signals, as recorded auscultations of the heart and lung sounds serving the process of clinical assessment of remotely situated patients, do not achieve a high enough level of agreement between specialized physicians. These findings should serve as a catalyzer for improving the process of telemedicine-attained bio-signals and their clinical interpretation.<\/jats:p>","DOI":"10.3390\/diagnostics13193153","type":"journal-article","created":{"date-parts":[[2023,10,9]],"date-time":"2023-10-09T05:07:13Z","timestamp":1696828033000},"page":"3153","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":7,"title":["Interpretation of Heart and Lungs Sounds Acquired via Remote, Digital Auscultation Reached Fair-to-Substantial Levels of Consensus among Specialist Physicians"],"prefix":"10.3390","volume":"13","author":[{"given":"Diana","family":"Magor","sequence":"first","affiliation":[{"name":"HIT\u2014Holon Institute of Technology, Holon 5810201, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Evgeny","family":"Berkov","sequence":"additional","affiliation":[{"name":"Internal Medicine Department C, Rabin Medical Center, Sharon Campus, Petah Tikva 494149, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dmitry","family":"Siomin","sequence":"additional","affiliation":[{"name":"Internal Medicine Department C, Rabin Medical Center, Sharon Campus, Petah Tikva 494149, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eli","family":"Karniel","sequence":"additional","affiliation":[{"name":"Internal Medicine Department B, Meir Medical Center, Kfar Saba 4428164, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nir","family":"Lasman","sequence":"additional","affiliation":[{"name":"Internal Medicine Department I, Chaim Sheba Medical Center, Tel-Hashomer 5265601, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Liat Radinsky","family":"Waldman","sequence":"additional","affiliation":[{"name":"Internal Medicine Department A, Chaim Sheba Medical Center, Tel-Hashomer 5265601, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Irina","family":"Gringauz","sequence":"additional","affiliation":[{"name":"Geriatric Department C, Chaim Sheba Medical Center, Rehabilitation Hospital, Tel-Hashomer 5265601, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shai","family":"Stern","sequence":"additional","affiliation":[{"name":"The Azrieli Faculty of Medicine, Bar-Ilan University, 8 Henrietta Szold St, Safed 1311502, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Reut Lerner","family":"Kassif","sequence":"additional","affiliation":[{"name":"Department of Pediatric Intensive Care, The Edmond and Lily Safra Children\u2019s Hospital, Chaim Sheba Medical Center, Tel-Hashomer 5265601, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Galia","family":"Barkai","sequence":"additional","affiliation":[{"name":"Beyond Virtual Hospital, Tele-Medicine Virtual Hospital, Chaim Sheba Medical Center, Tel-Hashomer 5265601, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hadas","family":"Lewy","sequence":"additional","affiliation":[{"name":"HIT\u2014Holon Institute of Technology, Holon 5810201, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3851-3245","authenticated-orcid":false,"given":"Gad","family":"Segal","sequence":"additional","affiliation":[{"name":"Beyond Virtual Hospital, Tele-Medicine Virtual Hospital, Chaim Sheba Medical Center, Tel-Hashomer 5265601, Israel"},{"name":"Education Authority, Chaim Sheba Medical Center, Tel-Hashomer 5265601, Israel"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2023,10,9]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","unstructured":"Cerdan de las Heras, J., Andersen, S.L., Matthies, S., Sandreva, T.V., Johannesen, C.K., Nielsen, T.L., Fuglebjerg, N., Catalan-Matamoros, D., Hansen, D.G., and Fischer, T.K. 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