Interrater reliability of spectrogram for detecting wheezing in children

BACKGROUND Auscultation is an easy way to evaluate and diagnose patients with lung conditions, but has the shortcoming of being subjective. Using the spectrogram, it is possible to visualize wheezing. We therefore conducted a study to compare the efficacy of diagnosing wheezing by auscultation versus diagnosing wheezing by spectrogram. METHODS This was an investigation of interrater reliability and agreement in which the subject population consisted of children, and the rater population consisted of pediatric pulmonologists. We recorded 55 respiratory sound files from June to November 2019. Three pediatric pulmonologists listened to the respiratory sound files and assessed whether wheezing was present. Additionally, all respiratory sound files were converted into spectrograms; the same pulmonologists viewed these and assessed whether wheezing was present. We performed interrater reliability and agreement testing as between the auscultation results and spectrographic results and investigated the diagnostic reliability of auscultation versus spectrogram. RESULTS As between the three raters of our auscultation respiratory recordings, agreement was 88% and reliability was good (kappa=0.76, p<0.001). As between the three raters of our spectrograms, agreement was 83% and reliability was good (kappa=0.66, p<0.001). Agreement between each rater's spectrographic findings and diagnosed wheezing was 91%, 75%, and 93%, respectively. On that subject, reliability was very good, moderate, and very good (kappa=0.82, 0.49, 0.85, p<0.001), respectively. CONCLUSIONS A spectrogram may be a valuable tool for evaluating wheezing in children. It may also be used to improve a young clinician's ability to accurately diagnose wheezing in the future.