The cold sensation of the doctor's stethoscope has been familiar to patients for decades. But the device could soon be replaced by new technology, a leading scientific journal has predicted. It claims that a new generation of hand-held ultrasound devices, modelled on smartphones, are able to diagnose heart, lung and other conditions quicker and with more accuracy than the 200-year-old stethoscope.
The editorial article, in Global Heart, the journal of the World Heart Federation, says: "Many experts have argued that ultrasound has become the stethoscope of the 21st century." Ultrasound works by emitting high-frequency sound waves to monitor the structure of soft tissue and blood flow.
The article adds: "At the time of writing, several manufacturers offer hand-held ultrasound machines slightly larger than a deck of cards, with technology and screens modelled after modern smartphones." There have been concerns that the devices offer inferior image quality compared with larger ultrasound machines. But the article suggests that these criticisms are outweighed by the speed with which some diagnoses can be made. The authors, Professor Jagat Narula, the editor, and associate professor Bret Nelson, of Mount Sinai School of Medicine in New York, claim that ultrasound can diagnose conditions and monitor the lungs, heart, intestines and blood flow with much more accuracy.
The stethoscope was invented in France in 1816, by Rene Laennec, a French physician, to listen to the heart of an overweight patient. Before the stethoscope, doctors would place their ear directly on to the patient's chest, a practice called auscultation. But because of the young woman's size, Laennec, thought it would be improper and inadequate to do so. Instead, he listened to her heart through a rolled-up sheet of paper, which magnified the sounds of her lungs. The paper was soon replaced by a wooden tube, similar to an ear trumpet. Over the course of the 19th century, this design was replaced by something more recognisable as the device used today.
The authors claim that the high cost of the smartphone-style devices, which can cost thousands of pounds, has been hampering their spread, but predict that their growth will continue. "Certainly the stage is set for disruption; as LPs were replaced by cassettes, then CDs and mp3s, so too might the stethoscope yield to ultrasound," they write. However, they concede that some doctors might be unwilling to hang up their stethoscopes, Dr Michael Dixon, chairman of the College of Medicine and a Devon GP, said: "I remain pretty addicted to my stethoscope.
It is so much a part of what we do and is very symbolic. It suggests treatment as well as diagnosis, and a connection. The problem for many is the alienation between doctor and patients that comes from computers. If you start to introduce more machines, it could have a negative effect."