It Must Be True: I Read It On the Internet!

On August 30th, this article in The Guardian touted a compelling headline: "iPhone Set to Replace the Stethoscope: Free iPhone app monitors hearbeat - and helps doctors save lives in remote areas". Wow! Can you believe that?? Well, maybe you can't.
 
The article focused on an iPhone app that allows a user to use the built-in microphone to auscultate the chest. Here's how they led the article: 
"The stethoscope – medical icon, lifesaver and doctor's best friend – is disappearing from hospitals across the world as physicians increasingly use their smartphones to monitor patients' heartbeats.
More than 3 million doctors have downloaded a 59p application – invented by Peter Bentley, a researcher from University College London – which turns an Apple iPhone into a stethoscope."
 
Sounds bloody amazing, innit? Well, not so fast. Let's not ring in the old "death of the stethoscope" dirge quite yet. Turns out that a correction needed to be published by the Guardian (they are running the correction now at the beginning of the article). 3 million docs hadn't actually downloaded the app. The maker said 3 million people had downloaded it. There's no way to know how many were actually physicians vs people downloading a free app as a novelty. Whoopsie. My bad.
 
This error was picked up by the folks at iMedicalApps in this post, "iStethoscope app will not replace the stethoscope - article by the Guardian is borderline reckless". It turns out iMedicalApps had reviewed the app months previously and dismissed it as an interesting app, but not sophisticated enough to really be used in a real medical setting, and certainly NOT at a level that would replace the good old stethoscope.
 
According to author Iltifat Hussain, the story had a lot of hype but not much fact to back up their tabloid-style claims, and their own testing showed it to be a bit lacking:
"Lets be clear what this application does. You take the bottom part of your iPhone, where the microphone is, and place it on the key auscultation points on your chest – Aortic, Pulmonic, Tricupsid, and Mitral. The app then enhances the sound that the microphone hears on your iPhone, and then you can supposedly use the sounds to detect heart pathologies.
Basically – it’s a glorified microphone – not something  you would want to detect life threatening cardiac pathologies with. On top of this, you have to place the microphone in exactly the correct place, and then assume your patient is thin and doesn’t have extra adipose tissue to distort the noise – not practical by any means.
I tried using the app on a range of people – from thin to not so thin, and I had great difficulty in even finding the correct orientation to place the phone. When I was actually able to pick up heartbeat like sounds, there was a great deal of artifact and muffled noise. This type of experience is echoed by the one to two star ratings of the app in the App Store. This cumbersome experience also shows why it’s relatively useless in a public health setting – contrary to what The Guardian story leads readers to believe."
 
So don't throw your stethoscope over for an iPhone just yet.
 
The other disconcerting aspect of this article is that the Guardian is syndicated and its news feeds are picked up by sources all over the Internet. So within hours, countless Web sites had already re-posted the article in its entirety or posted articles that not only summarized the incorrect data about the downloads but also regurgitated the hype. I have to agree with Hussain that this is borderline irresponsible journalism. Not only that, but when such hyperbole is used in an inaccurate manner, it taints the entire article and any actual factual content it contains.
 
In this case, the Guardian article actually goes on to discuss how regulations may be hampering the development of new technologies -- good points that may now be lost or disregarded by readers because the inaccuracies in the data and the hype about the death of the stethoscope will make readers skeptical of the article overall.
 
So there are two lessons here: one is that you can't believe every thing you read, and two is that crying wolf for the purposes of attention grabbing headlines might be detrimental to your credibility. Let's promote technology and medicine and the innovation that is coming from all these new devices accurately and responsibly. Don't be the butt of a joke in an article about "I read it on the Internet, so it MUST be true"...
PS: One comment worth noting was something along the lines of "I don't want to touch my iPhone against dozens of sick people every day -- YUCK!" So that's definitely another aspect of the iPhone stethoscope: disinfecting measures would have to be intense.

About the Author

Stephen Welch

Senior Vice President, Communications
Executive Editor, CHEST

This blog, "It Ain't Rocket Surgery" is intended to help busy health-care professionals find useful online and mobile resources that will enhance their self-education and professional research efforts, or point out important topics of discussion related to online information and content. The blog's title is a Yogi Berra style mash-up of two common phrases, "it ain't brain surgery" and "it ain't rocket science". I hope it will be casual, fun, insightful, and -- most of all -- educational.

You can follow me on Twitter. 

I currently serve ACCP as the Senior Vice President of Communications, as well as the Executive Editor of CHEST, the ACCP’s flagship journal. During my 15 years here, ACCP has focused on growing and developing the editorial, technological, and business aspects of the College. We are constantly striving to make the journal and other ACCP educational content as accessible and useful to clinicians as possible.

When not at work, I like to spend time scuba diving with sharks, collecting original comic book artwork, exploring the digital world, and searching for good BBQ.

Your feedback about the blog is always appreciated. So are tips on good BBQ joints.