The Ultimate Acoustic Stethoscope Review (page 7)
Conclusions and Recommendations:
combined the subjective and objective score to yield a total score and a rank
ordering. Our tests show that acoustic stethoscopes are like musical
instruments, each with its own personality. The results are shown below.
Click on the name to see the vendor's
description. Click on any thumbnail photo to see an enlarged photo.
Click on the name to see the vendor's description. Click on any thumbnail photo to see an enlarged photo.
The Littmann Cardiology III is an easy winner for the best stethoscope. It had high ratings in each of our test systems. It is efficient, making it easy to hear heart sounds even in patients with COPD. It readily discerned all heart sounds, including clicks and splitting of the S2. It had good ergonomics. It is pocketable, so it will appeal to surgeons as well as internists. It uses a small diaphragm in place of a bell, which in practice was no drawback. The small diaphragm was just as useful as a bell in achieving acoustic coupling on irregular surfaces, such as a bony patient. It does have a "tunable diaphragm" but the soft pressure required to accentuate low frequency sounds greatly decreases the sound volume, making the "bell mode" of the diaphragm of minimal usefulness. Overall it is an excellent choice and is well suited for internists, family physicians, pediatricians, surgeons, and nurses. It's relative freedom from external noise interference also makes it a great choice for an EMT worker. The downside is its high price tag.
The Omron Sprague Rappaport is our selection as best buy. Its acoustic performance rivals the Cardiology III at a fraction of the price. The Omron is an excellent choice for students short on money, to stock your exams rooms with, or to keep as a spare stethoscope in your car or desk. It's drawbacks are its bulk and susceptibility to noise artifacts from rubbing the tubes together. However anecdotal accounts describe EMT's using this scope with the tubes taped together, something we didn't try. Some people find the hard earpieces to be uncomfortable.
Physicians or health care workers who want a pocket sized stethoscope may also want to consider the Littmann Classic II SE, which had very good performance in a compact form, or the Littmann Master Classic II with excellent performance of its single head diaphragm. The nursing single head stethoscope was extremely compact weighing just 2.4 ounces, and is bargain priced. It had fair performance despite its toy-like appearance. The ADC Platinum Cardiology is a beautifully made single head stethoscope which gives acceptable performance at half the price of the Littmann Master Classic II that it resembles.
The Welch Allyn Harvey Tycos Elite is unique and deserves a mention. It is less efficient than the other scopes, and the ribbed diaphragm makes it difficult to achieve acoustic coupling on a thin bony patient. In these settings you must use the Bell. The Welch Allyn was the only scope with a "soundstage" or a sense of imaging. This is consistent with its namesake, the great clinical cardiologist W. Proctor Harvey MD. He used to train his students by having them listen to a symphony and concentrate on a single instrument within the orchestra, one at a time. He then taught his students to concentrate on one cardiac sound at a time. In similar fashion you can isolate individual components of the heart sounds best with the Welch Allyn, but you need sensitive hearing to do this due to the relatively low efficiency of the scope.
There is a final caveat of buyer beware. There are many stethoscopes advertised as "Cardiology III". But they aren't manufactured by 3M. Many of these appear identical to the Allheart model we tested. This stethoscope is a Chinese made copy of the (discontinued) Littmann Cardiology I. The Littmann Cardiology I had superb acoustics, but suffered from having too short of a tube. The Littmann Cardiology I clones have longer tubes, but their acoustic performance is inferior to the original. Plus some of the clones suffer from manufacturing defects.
Littmann Cardiology III
Omron Sprague Rappaport
|Littmann Master Classic II||$87.95||29.5||3|
|Littmann Cardiology I||Discontinued model||29.3||4|
|Littmann Classic II SE||$68.00||28.4||5|
|Welch Allyn Tycos Elite||$136.00||26.6||6|
|Prestige Sprague Rappaport Stealth||$26.50||23.9||7|
|ADC Platinum Cardiology 615||$43.13||23.8||8|
|Single Head Nursing Stethoscope||$6.78||23.3||9|
|ADC Adscope Professional 603||$38.99||21.8||10|
|DRG Puretone Traditional PT3||$79.98||17.3||12|