Embedded Linux On a Digital Stethoscope 111
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? (Score:4, Insightful)
Re: (Score:1)
Re: (Score:1)
Re: (Score:2)
Re: (Score:2)
On the other side, having a historical record of your heartbeat / breathing (lung) sound could help in some medical cases...
Re: (Score:2)
put another way, let's say their project was to build an amplifier. in theory, they could design the whole thing with discrete components. but in reality, using an off-the-shelf op-amp in the design will yield better results than they could ever achieve.
Re: (Score:2)
put another way, let's say their project was to build an amplifier. in theory, they could design the whole thing with discrete components. but in reality, using an off-the-shelf op-amp in the design will yield better results than they could ever achieve.
But one method will teach you about the basics of amplifier design, the other will teach you how to click the buy button on amazon or whatever.
The reason these people have chosen Linux is that they can strip out as much as possible that they do not need and have a fairly small kernel. Then they can still write some code that does everything they need to for their project on another linux box and cross-compile it for the tiny kernel they created earlier.
Re: (Score:1)
Re: (Score:1)
Archiving, Comparing, etc. (Score:5, Insightful)
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.
Re: (Score:2)
Re: (Score:1)
Re: (Score:2)
Until, like the GP suggested, you want to run a network stack and encrypt the traffic. Or compile fftw or some
Re: (Score:2)
And cramming all of this onto the stethoscope rather than on a PC is better because???
Re: (Score:2)
Maybe doctors want to wear stethoscopes instead of PCs around their necks?
Real time answer? (Score:2)
However, a caveat, most diagnoses come from the history. Maybe 5% of the time does physical exam finding
Re: (Score:2)
Shove some memory into the stethoscope and have it able to record what's going on. Alternatively upgrade all the bed-head stations whereby the patient's interactive screen doubles up as a medical computer (I've seen these used in places around the UK, but can't remember the brand name. Quite cool though) and include a USB port for a specialised external microphone (Think ultrasound scanner, but with the cold metal bit). That wa
Re: (Score:1)
Versality at few additionnal cost (Score:2)
Oh ! You meant why *this particular* electronic-stethoscope project chose *a full uCLinux* as its particular software ? /.
If you need to ask such a question, I think your geek is at risk of being revoked here around at
Now, if you don't mind I'll go back at "Beowulf cluster of Linux-running t
Re: (Score:2)
well, OK, as a former student myself that went through a sr. design project, i'll give my own perspective. one
Re: (Score:2)
Re: (Score:2)
And, of course, once the data has been captured by whatever primary piece of equipment you're using, it can analyze it in software re
Pocketable... (Score:2)
Thus it may be useful to have a small MP3-player sized (and functionally not much different anyway) smart device that can fill in your pocket instead of needing to connect a dumb device to a PDA or a PC.
Use the device as a regular stethoscope most of the time and only plug to a Palm or a PC/Mac desktop whenever you need it (for more complex processing or visualisation, and to of
Re: (Score:2)
rj
Re: (Score:2)
Re: (Score:2)
Re: (Score:2)
Now, a REAL feat would be... (Score:3, Funny)
Re: (Score:1)
Oh I tried that, but had to say "Hasta La Vista!" to it 'cause it just wouldn't bend to my needs.
Re: (Score:3, Funny)
This is not going to go very far... (Score:2, Interesting)
There may be, however, a solution looking for a problem in the fact that the audio can be recorded for playback later. However, I can see a situation where a doctor is sued for malpractice, and the audio is used against him rather than for him in the case. I'd be rather wary of using this machine, based on those grounds alone.
Re: (Score:1)
simple example - patient see's doctor, walks out has heart attack, sues doctor claiming he should have diagnosed him, doctor plays back perfectly normal sounding heart beat. that kind of thing really comes down to how confident you are of your abilities...
Re: (Score:2)
Note: I am a medic, not a doctor, so if I'm wrong please correct me.
Re: (Score:2)
Re: (Score:2, Insightful)
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 there was no reasonable way for him to know a person had a certain illness that related to it.
Re: (Score:2)
Re: (Score:2)
This is a problem within healthcare with any new technology or system. The solution is to ignore the traditionalists and go for the younger doctors. Doctors are very competitive and anything that improves the clinical capabilities will eventually permiate the local community due to peer pressure.
Hook me up with that... (Score:5, Funny)
Re: (Score:3, Insightful)
Re:this linux crazyness... (Score:5, Funny)
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... (Score:5, Funny)
You are wrong about this one. The spoon project still exists. It just got sporked.
Re:this linux crazyness... (Score:4, Funny)
Re: (Score:1)
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.
I recommend watching the documentary that was made a few years back about the spoon project, where a journalist tried to get to the bottom of what the project was about. It turns out there was two major groups, one who wanted to virtualize everything and use it to power stuff, the other group wanted it to be free to use as people saw fit. There were several fights between the groups, and even some explosive discussions. I think one of the telling moments of the documentary was when one of the young develop
Re: (Score:2)
Re:this linux crazyness... (Score:4, Funny)
There is no spoon.
Rockbox? (Score:2)
limited clinical usefullness (Score:5, Informative)
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.
Re: (Score:3, Insightful)
Stethoscopes either traditional or digital really aren't designed to diagnose anything in a clinic setting at least not where more accurate tests are availible. But that doesn't mean that they don't save a heck of a lot of time determining what to test for. Not to mention you seem to ignore areas of medicine such gastroenterology, pulmonology and emergency medicine.
Re: (Score:1)
'Determining what to test for' is diagnosis
In gastroenterology the only use of a stethoscope would be to listen for bowel sounds (increased if there is obstruction). This does not need any great audio resolving power. In 'pulmonology', i.e., respiratory medicine, bedside diagnosis with a 'scope is a thing of the past. V/Q scanning, VO2 testing, bronchoscoping, or even simple CXR are what lead to diagnosis. In emergency medicine I can't think of any situation where a stethoscope would be useful (other than
Re: (Score:1)
Assessment of any patient in an emergency setting starts with the ABCs, and you can't assess breathing without listening. Auscultation of breath sounds can reveal a lot about a patient's airway and breathing status, and it takes less than 10 seconds to do. Also, you cannot always get and don't always want to rely on an automatic BP, but then nurses do that. You don't seem to have a very deep understanding of how emerg
Re: (Score:2)
The only time that a stethoscope is of real use to me is in an ICU setting to sort out a post-infarction VSD vs. papillary muscle rupture. And, either way, no one will take an individual to the operating
Re: (Score:1)
completely agree.
more formally, one way the 'usefullness' of a diagnostic test can be assessed is in terms of positive predictive value [wikipedia.org]. I suspect the ppv of electronic vs ordinary stethoscope would be very low
Also, apocryphally, a poor stethoscope may be very helpful: in general practice if a murmur is loud enough for you to hear with a 'cheapo' stethoscope its probably serious enough for you to do something about it, if you can't hear it with a cheapo stethoscope you probably don't need to worry !
Re: (Score:2)
The echocardiogram to prove it was harmless will bring in $600 of revenue.
Re: (Score:1)
You really, REALLY need to get outta the healthcare industry. Maybe you can get shunted off to a job at the FDA as one of the people obstructing advances in Medical Device development. You could be one of the people with the
Re: (Score:2)
Also, the history of the present illness is so important that it trumps just about everything else.
I do agree that some tests are over-ordered, but it's not apparent that cutting down on tests will either improve mortality or decrease total costs to the health
Re:limited clinical usefulness (Score:2)
I have to agree. Most US ERs have a RN doing triage in any situation besides disasters. (Which is funny to watch the poor internist to route people though a hospital during a drill, they don't know where to send people in a larger facility, 500+ beds, sometimes sending patients to rooms that do not exist.) The RN will take the major symptoms and cat1 the patient if there is any cause is tripped as defined by protocols. However, usually triage isn't as bad as people make it out to be, it is the hellhole afte
Re: (Score:2)
Re: (Score:2)
That being said, I've h
Re: (Score:1, Insightful)
The comments seem to be very 'everyone just uses
Re: (Score:2)
I've personally picked up a number of minor heart defects - usually MR - on auscultation when assessing patients pre-operatively, which have then been confirmed by echo. We could echo everyone pre-op but that would be a poor use of resources.
I'm not sure of t
Re: (Score:2)
Auscultations to listen to breath sounds for instance, how about that? Saying its not useful because its not perfect is silly - lets say you are examining a patient and have suspicions of a respiratory disease / cardiac issue /
possible scenario (Score:1)
Doctor: Oh my, you seem to have arrhythmia!
Patient:?!?!
Doctor: Oh sorry i forgot to turn off the mp3 player, that was just a Murcof track, my bad.
Electronic stethoscopes (Score:1, Informative)
http://www.medicom.bang-olufsen.com/sw435.asp [bang-olufsen.com]
The problem is that the sound quality is too good for conservative doctors, so they had to make a function that imitates the sound from an old tube stethoscope.
I can't wait for... (Score:2)
Re: (Score:2)
I really hope this fails approvals (Score:3, Interesting)
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
Re: (Score:1)
Re: (Score:2)
Think about a patient in a rural hospital. If they are lucky, there is an experianced physician on-call, but more likely they have an RN or LPN to deal with. A nurse or technician could record the sound and send it for a "wet read" to a remote physician. This is the model used by tele-radiology currently. Then a local physican could make a "dry read" in the morning. In a place with only a couple of physicians in the local area, such technologies would be invaluable.
huh? (Score:1)
Do you have any pointers to actual decision makers talking about this "perceived difficulty"?
And why would anybody think anyway that open source software should have a harder time getting approved than closed source software?
Re: (Score:1)
Re: (Score:1)
In principle, open source code needs to be revalidated no more and no less between changes than closed source. The difference is that with closed source code, manufacturers never find out about a lot of changes or bugs, so they can pretend they don't have to validate the code or worry about those bugs.
Hopefully, the courts will sooner or later realize that this use of closed source is not just irresponsib
Re: (Score:1)
Well, you have failed to come up with any reasonable argument for why that should be cheaper for COTS than for open source software. The only reason it would be cheaper is if COTS is audited less thoroughly.
Just because random joe blow on the Internet doesn't get to browse through a codebase doesn't render it automatically suspect.
Of course, I'm assuming that the people doing the
Re: (Score:2)
I've been involved in the design and implementation of a few medical and bio-medical instruments.
All software used in medical instruments submitted to the FDA, whether commercial-off-the-shelf (COTS), OSS, proprietary or otherwise must be validated for use in the instrument. This usually includes extensive documented testing.
COTS software is usually considered easier to validate for a variety of reasons : if it is a largely used piece of software (say Excel), it is likely its usage in other medical in
Re: (Score:2)
Yeah, great reason to use closed source...
Re: (Score:1)
Quite to the contrary: OSS comes with complete, auditable changelogs, cryptographic checksums, full bug databases, and published, down-to-the second correspondences between releases and source code. Almost no commercial vendor (certainly not Microsoft) gives you that level of information and detail.
There are only "fewer versions" of software like Excel because commercial companies often patch software without changing the version number, and because they leave many k
Re: (Score:2)
I said I had been involved with designing medical and bio-medical instruments, I didn't say I made the rules, nor did I say I approved of them. Talk about jumping the gun.
For the record, I publish OSS and I'm not with a company. I merely explain why OSS is not popular with medical instrument designers: it makes more work for them. The onus is generally on the user to prove OSS suitable for their instrument, whereas for COTS this is not quite the case.
Some software h
Sounds like nothing more than a bit of fun.. (Score:1)
Re: (Score:1)
Re: (Score:1)
FDA approval should not be a problem (Score:1)
Re: (Score:1)
There are three main classes of medical devices, ranging from bedpans to implantable pacemakers/defibrillators. All devices introduced to the market require regulatory oversight and qualification.
To be frank, the medical device industry has it all sew
This could become useful (Score:3, Informative)
Although the original design does not include waveform diagnostics, analysis, and display capability, that could be added later at little cost.
can anyone explain... (Score:2)
Quote from Wikipedia [wikipedia.org]:
Infectious Diseases (Score:1)
Rare? Sez who? (Score:1)
There are certainly more windows-based diagnostic devices than other OSes, but I would hardly call Linux "rare" out on the floor.
Re: (Score:1)
If you can give us any info, reply to this post or contact us using the email address on our contact page [calvin.edu].
- David
[ Rhythm Reloaded ]
http://www.rhythmreloaded.c [rhythmreloaded.com]
bs statement in article (Score:2, Insightful)
That is totally inaccurate. There are plenty of medical devices in use running Linux, and they all get FDA approval without any issue. As long as you go through the same procedures in testing/quality-assurance and documentation it's all the same end result to the FDA. Even in the case of software which is complex relying on other pieces of software, black box testing solv
Open source NOT a problem for FDA (Score:3, Informative)
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]
Re: (Score:1)
If anyone has a concrete example they could give, we would appreciate it. Reply to t
But wait... (Score:1)
Re: (Score:2)
Yes, and I CAN imagine a Beowulf cluster of them.
Embedded Linux On a Digital Stethoscope (Score:1)
Even better (Score:2)
Bullpucky! (Score:2)
Horseapples! I've worked in this industry and that is most certainly not the answer. The reason you don't hear more about Linux devices in the medical field is one of two reasons: 1) The high demand for real time systems, which Linux hasn't been that great at historically; and 2) They're not telling you about it! I've worked in the field developing system software, and not onc