![]() ![]() Despite the fact that the diagnostic accuracy of lung auscultation is widely debated, the stethoscope is still a first line diagnostic tool and used for clinical or therapeutic decision-making. To date, it is still ambiguous how this diagnostic tool contributes to the diagnostic work-up for various pulmonary entities. Nowadays, physicians might not be in the position to spend that amount of time to evaluate chest sounds, potentially leading to an inefficient and superficial examination, giving a delay in further diagnostic work-up and treatment 3, 4. However, detailed auscultation alone can take up to 10 minutes 3. History taking and a detailed physical examination, including auscultation, are considered essential parts of clinical examination. ![]() Auscultation of the respiratory system is non-invasive, safe, inexpensive and easy-to-perform. The use of the stethoscope is considered an essential skill in the medical profession and is often chosen for its’ ease of use, as well as for its’ appearance and reputation 2. Laënnec invented the most common symbol of medicine: the stethoscope 1. Only in resource limited settings, with a high prevalence of disease and in experienced hands, lung auscultation has still a role. When better diagnostic modalities are available, they should replace lung auscultation. Lung auscultation has a low sensitivity in different clinical settings and patient populations, thereby hampering its clinical utility. Results are limited by significant heterogeneity. Abnormal breath sounds are highly specific for (hemato)pneumothorax in patients with trauma. LRs and AUC of auscultation for congestive heart failure, pneumonia and obstructive lung diseases are low, LR− and specificity are acceptable. For 34 studies the overall pooled sensitivity for lung auscultation is 37% and specificity 89%. A meta-regression analysis is performed to reduce observed heterogeneity. Main outcomes are pooled estimates of sensitivity and specificity with 95% confidence intervals, likelihood ratios (LRs), area under the curve (AUC) of lung auscultation for different pulmonary pathologies and breath sounds. Studies concerning adult patients with respiratory symptoms are included. This meta-analysis aims to evaluate the diagnostic accuracy of lung auscultation for the most common respiratory pathologies. ![]() However, there is much debate about the diagnostic accuracy of this instrument. The stethoscope is used as first line diagnostic tool in assessment of patients with pulmonary symptoms. ![]()
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