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- W2067954549 abstract "To the Editor: An interesting contibution to the understanding of cardiac examination has been made by Ishmail et al,1Ishmail A.A. Wing S. Ferguson J. Hutchinson T.A. Magder S. Flegel K.M. Interobserver agreement by auscultation in the presence of a third heart sound in patients with congestive heart failure.Chest. 1987; 91: 870-873Crossref PubMed Scopus (90) Google Scholar who have reported considerable disagreement in the auscultation of S3 under working conditions. I suggest that a standard for the presence of an S3, such as phonocardiography or perhaps majority opinion of the examiners, would have strengthened this contribution in two ways. First, estimates of the overall S3 prevalence and of the sensitivity and specificity of auscultation for S3 could have been made. Since reliability varies with these parameters, these data would be useful for gauging reliability in screening for (low prevalence of S3), or managing (high prevalence) disease. Secondly, using a standard would have made the reasons for disagreement more clear. For instance, showing similar sex-specific prevalences of audible and “standard”-detected third heart sounds would have been stronger proof against sex as a cause of variability. Furthermore, documentation of changes in intensities of S3s and noise between examinations or with provocative measures would have addressed these as sources of variation rather than interexamination time intervals. Reporting of the heart rate during examination may have been a meaningful disclosure. Definition of the sources of error is important if measures to minimize variation are to be found and ultimately realize the hope for improved skills expressed in the article's accompanying editorial.2Stapleton J.F. The third sound of heart failure.Chest. 1987; 91: 801-802Crossref PubMed Scopus (3) Google Scholar I hope that Dr. Ishmail and colleagues continue their important work towards fulfilling this goal." @default.
- W2067954549 created "2016-06-24" @default.
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- W2067954549 date "1988-11-01" @default.
- W2067954549 modified "2023-10-17" @default.
- W2067954549 title "Auscultation of S3" @default.
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- W2067954549 doi "https://doi.org/10.1378/chest.94.5.1119b" @default.
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