Embedded Linux On a Digital Stethoscope

An anonymous reader writes "A team of electrical and computer engineering students at Calvin College is designing a digital electronic stethoscope running uClinux as its operating system. While there are many embedded devices built on Linux operating systems, medical devices running open-source software are extremely rare because of the perceived difficulty in obtaining FDA validation. The device is in its early stages of development, but major hardware choices have been made, and the team has recently released a Project Proposal and Feasibility Study."

Why?

OK I'll bite. Why does a stethoscope need an OS in the first place? How much file I/O, multitasking, networking etc. does a single-purpose device like this really do?

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I agree and considering the trend, this part of the medical process would soon be done by robots. For most of us, the annual medical checkup (stethoscope part) is the only time we get touched by the opposite sex (hopefully)... This is truly a sad day in hi

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well, basically, some script kiddies (sr. engineering design team) are hooking up a stream ripper to a pair of Bose noise-reduction headphones. so not a whole lot, really. but it mostly comes down to not reinventing the wheel.

put another way, let's say t

Archiving, Comparing, etc.

Disclaimer : I A A MD.

Currently, any exam can be recorded, stored, shared with an expert for additional advices, compared for reference, you can build libraries for teaching or for personnal reference, you can reprocess these data off-line to "clean them", you can mine them to discover whatever interests you, you can reproduce that data using a different way to display it (using false color instead of greys to help visualise contrasts, or more complex math like using fast fourier to transform Doppler-echo noises into a nice colored graphic) etc...

This include everything from the most high tech devices like 3D scanners, MRIs, etc. to the most simple technical examination (electrocardiograms) or even the most trivial step in examination : overall visual aspect (digital photo cameras are a very valuable tool in several arrays of medicine including dermatology and surgery).

And with all this digitalised information, you can even throw computer at the task of helping the clinicians. MRIs comes easily as an example where computer may help making something useful out of the data. But even much simpler exams like electro cardiogramme nowadays include small embed chip that can automatically recognise a couple of pathologies. Most modern machine will print in nice small message like "90% suspicion of grade I atrio-ventricular blocking", in addition of the actual tracks.
(And in fact modern defibrillator heavily rely on on-board electronic intelligence. The iron-like you still see in movies aren't used that much. The modern ones are semi automatic : you stick two big electrodes on the front and side of the chest. the machine goes automatically an ECG, decide the procedure to follow, and announce on a small embed screen and using voice. The practitioner only has to push a button to confirm and do the shock if he agrees with the machine's conclusions. Everything is automatic and comes with voice instruction so even untrained personal could use it).

Everything recordable and digitilized ? No. Nearly everything.
The century old stethoscope isn't. You use it, you hear something, but you can't share it or store it for further reference.
Meanwhile, there's a lot of information that trained doctor can hear in the stethoscope.
But it's hard to show to other (you can store it in a library to keep it for a lecture, you can't point it with a finger on the graph to a student), the student need luck to be around when there's something interesting for her/him to hear. It can't be reproduced.
It's almost some kind of voodoo art, where you have a couple of old expert who can diagnose almost anything with a simple stethoscope and by looking how the patient walk to enter the room. But they can't easily transmit their art. Sometimes you just wish you could keep them stored in formaldehyde.

This gadget that those engineer are working on is a nice alternative to the formaline. A simple gadget that'll help store, archive, send, etc. the noises you may encounter when examining with a stethoscope.

Also, I happen to be a little bit hard hearing. Not much. I doesn't pose any problem in normal life (I can enjoy classical music concerts for example). But when it comes to hearth noises, I start to show my limits and I suck with a stethoscope.
Such a device could enable me to obtain better (cleaned of noise) signal. Or even, as the devices use apparently open source software (uCLinux), it won't be too difficult to bolt in some crypto+network capability and display a visual representation of the sound on my Palm's screen.

I really think that throwing some electronics inside the stethoscope was long due, and I'm happy that the problem is currently being tackled with open source software.

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well, they're students, so it's unlikely they have a wealth of experience to draw from and know what will work before even beginning. and (this is my assumption) it looks like the device would not normally be connected to a USB port, but be standalone. i

Now, a REAL feat would be...

...installing Windows Vista on the aforementioned stethescope. Would there be room enough for McAffee?

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Doesn't matter, it still wouldn't detect viruses.

This is not going to go very far...

I can't see this going very far. What doctor will wrap that thing around his neck? Unless, of course, it also plays MP3 files.

There may be, however, a solution looking for a problem in the fact that the audio can be recorded for playback later. However, I

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The problem is, that heartbeats can be used to _find_ illnesses, but not to disprove them. So in no case will a heartbeat prove that a patient was healthy, yet, a heartbeat can prove that a patient was sick. To prove that a patient is healthy, a whole batt

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You're wrong.

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well, i can't say i agree with you because erratic or racing heart beats are a vital clue to many illnesses.

my partner's rapid heart beat was what lead to her being diagnosed with a certain illness. a doctor could very well play back the beats to show the

Rockbox?

I think if I was doing this, I would have started with rockbox [rockbox.org] - it already has all the audio playback and recording, runs on cheap, easily portable hardware (MP3 players). I'm assuming you only need 2 channels of audio input - otherwise you might have som

limited clinical usefullness

littmann [3m.com] make a variety of stethoscopes including digital ones, and have done for some time.

However, dont believe the hype. They are of very limited clinical value. No hospital cardiology diagnosis these days would be based on auscultation. (echocardiography [wikipedia.org] would be used). For taking BP the traditional tube plus ear-pieces 'scope more than suffices.

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They are of very limited clinical value. No hospital cardiology diagnosis these days would be based on auscultation.

Stethoscopes either traditional or digital really aren't designed to diagnose anything in a clinic setting at least not where more accurate

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Well, you said what I was going to say + here is another one: http://www.thinklabsmedical.com/electronic-stethoscope/products/ [thinklabsmedical.com] The only time I can think of that a stethoscope has been used consistently and necessarily for the management of a patient is po

I can't wait for...

the look on someone's face when the thing locks up while in use. Either this man is dead or my linux driven digital stethoscope needs a reboot.

I really hope this fails approvals

not because it doesn't work, but simply because it's such a dumb idea.
OK, I realise that most of the other replies are critical, too

Really this is just using tech. for it's own sake - and introducing a whole bunch of unnecessary problems into what is really a very simple procedure. Instead of a simple piece of rubber tube, with a "thingy" at each end you are now reliant on an embedded device with it's own power requirements, a link to a host PC with software compatability and yet more power requirements and finally the doctor or nurse wears a headphone to listen to exactly the same sounds they'd hear through a conventional stethoscope.

there is a slight glimmer of hope for this: remove the doctor.
If you can possibly make this device totally idiot-proof and throwaway cheap, it might just find a use for remote diagnostics, where a patient can self-monitor, upload their "swooshing" noises to an AI which does most of the work.
Of course this presuposes that the patient isn't too busy having a heart attack, and can get their PC connected up to the net, and the battery in the device hasn't gone flat, and the AI at the other end is working, and someone can take the necessary action (if needed).

On second thoughts, scrub the glimmer of hope. There are just too many things can go wrong

This could become useful

There are electronic stethoscopes available, but they are expensive and noisy. The ability to electronically produce a clean sound from a stethoscope would have some niche uses, primarily in the educational area. It would be nice to be able to allow a gaggle of interns to hear a patient's heart rather than to have each of them have to listen individually with their own stethoscope. I wonder if the designers have included Bluetooth in the original design. As was already mentioned there may be pros and cons to recording stethoscope sounds; I tend to believe that recording the sounds would become desirable for some doctors. Doctors tend to record and document everything as it is, and this could make it practical to record stethoscope sounds, Yeah, the prototype may be big, heavy, and a battery pig; that means that there are many opportunities to reduce its size, weight, and power consumption.

Although the original design does not include waveform diagnostics, analysis, and display capability, that could be added later at little cost.

Open source NOT a problem for FDA

I work for a manufacturer in the pharmaceutical industry and I hear people say things like Linux and/or Open Source is a problem with the FDA, but I haven't seen anything yet to back that up. Period.

To "validate" software with the FDA, you really only need to do three things:

1) Make your software/system/device secure
2) Have control over the system
3) Document #1 and #2

There are people who come from an old guard that have all sorts of misconceptions about what can and can't pass FDA regulations. It seems to stem from a gross misunderstanding of what the regulations actually say.

I've read the portions that deal with computers and electronic information. There is absolutely nothing in it to suggest open source even remotely is an issue. I suspect this is an urban legend started by companies selling proprietary software.

Regardless, the regulations (Part 11) are the FDA Bible and so long as you can satisfy the requirements in them which basically boil down to the three I listed above, then you are in compliance.

To convince yourself this is true, read this. [fda.gov]

Hook me up with that...

I would date a girl who runs linux. Sadly, I think that women will remain closed-source at least for the rest of my lifetime.

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...that and a very restrictive license that could easily go to several thousands of bucks in fines and fees if violated...

Re:this linux crazyness...

does my spoon run linux?

No. There was a project to port Linux to the spoon, but there was a lot of infighting about future directions and major members left, so the project was effectively shelved.

does my dog run linux?

What breed of dog? Seriously, if you want help from the community you have to specify the exact breed of the dog and anything else which might help someone come up with an answer for you...

does my gf run linux?

What's a gf?

is the water linux friendly?

If it's normal H2O then yes, probably. Some people have reported issues with Deuterium and Tritium when used with Linux. ymmv.

will consuming that extra donut will have marginal effect on penetration of linux?

To quote Homer Simpson - "Donuts. Is there nothing they can't do?"

Re:this linux crazyness...

No. There was a project to port Linux to the spoon, but there was a lot of infighting about future directions and major members left, so the project was effectively shelved.

You are wrong about this one. The spoon project still exists. It just got sporked.

Re:this linux crazyness...

Actually, the spoon project did fork into a knife project.

Re:this linux crazyness...

does my spoon run linux?

There is no spoon.