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Wheezes, crackles and rhonchi: simplifying description of lung sounds increases the agreement on their classification: a study of 12 physicians' classification of lung sounds from video recordings
  1. Hasse Melbye1,
  2. Luis Garcia-Marcos2,3,
  3. Paul Brand4,5,
  4. Mark Everard6,
  5. Kostas Priftis7 and
  6. Hans Pasterkamp8
  7. The ERS task force for lung sounds
  1. 1Faculty of Health Sciences, General Practice Research Unit, UIT the Arctic University of Norway, Tromsø, Norway
  2. 2Pediatric Respiratory and Allergy Units, Arrixaca University Children's Hospital, University of Murcia, Murcia, Spain
  3. 3IMIB-Arrixaca Biohealth Research Institute, Murcia, Spain
  4. 4Princess Amalia Children's Center, Isala Hospital, Zwolle, The Netherlands
  5. 5Postgraduate School of Medicine, University Medical Centre and University of Groningen, Groningen, The Netherlands
  6. 6School of Paediatrics, University of Western Australia, Princess Margaret Hospital, Subiaco, Western Australia, Australia
  7. 7Children's Respiratory and Allergy Unit, Third Dept of Paediatrics, “Attikon” Hospital, University of Athens Medical School, Athens, Greece
  8. 8Section of Respirology, Dept of Pediatrics and Child Health, University of Manitoba, Winnipeg, Manitoba, Canada
  1. Correspondence to Dr Hasse Melbye; hasse.melbye{at}


Background The European Respiratory Society (ERS) lung sounds repository contains 20 audiovisual recordings of children and adults. The present study aimed at determining the interobserver variation in the classification of sounds into detailed and broader categories of crackles and wheezes.

Methods Recordings from 10 children and 10 adults were classified into 10 predefined sounds by 12 observers, 6 paediatricians and 6 doctors for adult patients. Multirater kappa (Fleiss' κ) was calculated for each of the 10 adventitious sounds and for combined categories of sounds.

Results The majority of observers agreed on the presence of at least one adventitious sound in 17 cases. Poor to fair agreement (κ<0.40) was usually found for the detailed descriptions of the adventitious sounds, whereas moderate to good agreement was reached for the combined categories of crackles (κ=0.62) and wheezes (κ=0.59). The paediatricians did not reach better agreement on the child cases than the family physicians and specialists in adult medicine.

Conclusions Descriptions of auscultation findings in broader terms were more reliably shared between observers compared to more detailed descriptions.

  • Clinical Epidemiology

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