App Review: Thinklabs One Digital Stethoscope

If you were to ask any physician, "What is the one piece of equipment you cannot leave the house without?" Though I am sure there are a few that would say their smartphone, I would guess that most physicians would probably say their stethoscope.

Rating

Pros: Construction, Lightweight, Sensitivity, Versatility in use depending on clinical situation, great customer support, "cool factor."

Cons: Does require intermittent charging, iOS app needs to be updated to support 64 bit architecture of iOS11, pricey ($499).

The first stethoscope was created by Rene Laennec in 1816. But George Cammann developed essentially the standard binaural stethoscope in 1852, which has been the basis for current day stethoscope design. While digital and electronic stethoscopes have been introduced, they have kept the same design of a traditional stethoscope. For approximately 200 years, our main diagnostic tool has essentially been unchanged. All stethoscopes work in the same manner - transmitting sound from a chest piece through hollow rubber tubes to our ears. There really is no need to change. If it isn't broke, why fix it?

Well, a company from Colorado, ThinkLabs Medical, begs to differ. They are known for producing high- end stethoscopes. But their product, the ThinkLabs One, has taken the classic design of the stethoscope and has given it a modern twist. Their creative stethoscope is only the chest piece. No earpiece. No tubing. No stem.

The digital chest piece is an electronic device, which is battery powered and houses a very highly sensitive microphone that can amplify the sound captured 100x. The sound can be filtered between low (heart), midrange, and high (lung) frequencies. And there are filters to keep out ambient noise. But no earpiece.

How do you hear using the device? There is a 3.5mm phone jack so the physician can use a pair of quality headphones or earphones. Plus, you can connect it to your smartphone or tablet to record the sounds and waveforms with ThinkLabs' app (which is both iOS and Android compatible). At this time the iOS app has not yet been updated to support the new iOS11.

The unit is fairly lightweight even though it is slightly bulkier than the average stethoscope chest piece. But given that all of the electronics are in the chest piece it is surprising that it isn't much larger than the normal stethoscope chest piece. The unit ships with a protective case which includes the USB charging cable, ThinkLink adapter, and cables as well as a set of ear buds. It does cost $499 which is on the higher end of other digital stethoscopes, but it does have a radically different design.

The chest piece has a sapphire crystal display which indicates battery level, volume, and frequency selected. It is constructed of polished aluminum. The headphone jack also serves as the charging port, typically requiring 1-2 charges per week, depending on the amount of usage. There are four buttons. The top two buttons adjust the frequency of the stethoscope (i.e. bell vs. diaphragm mode), while the bottom two adjust the volume. Pressing any of the four buttons will power on the device and there is an auto shut off mode which turns it off to conserve battery.

The stethoscope ships with an adapter called the ThinkLink which allows you to connect the stethoscope chest piece to your smartphone and then connect your headphones/earbuds to the ThinkLink. This not only allows physicians to auscultate the patient, but also to record heart or lung sounds to their app or other third party audio recording app.

In an academic setting, imagine allowing students or residents to hear a finding all at once through a speaker as a group, rather than having a patient disturbed to be examined on separate occasions.

Other clinical settings allow a physician to attach a Bluetooth adapter to the chest piece and use Bluetooth headphones and use the device on a patient with contact isolation precautions. A doctor can also use the device for telemedicine, so the clinician on the other end can hear the chest exam in real-time rather than with a recording.

In practice, I found the ThinkLabs One to be easy to use. It is by far the lightest stethoscope I have ever used. I don't like to wear my coat while working in the emergency department, so I tend to wear my stethoscope around my neck. Switching to the ThinkLabs One was revealing-I never realized how much that rubber tubing weight was noticeable until using this stethoscope. I found the stethoscope to be quite sensitive on the lowest settings compared to my non-digital stethoscope and was able to hear clearer especially in a bustling ER. I found myself using a pair of wired Beats earbuds with the device. I find that the bass brings out the heart sounds better compared to the included earbuds-besides its kind of neat when the patients look at you and say "Cool, that's your stethoscope?"