What to Look for in an Electronic Stethoscope

The electronic scope market is different from the acoustic scope market for a few key reasons. First, there just aren't that many electronic models from which to choose. Second, because price points are relatively high – $199 to $600 or more – you really need to assess the parameters that matter to you.

Although the designs and approaches differ wildly, there are essentially two tiers of electronic scopes. Basic models focus on amplification and filtering/ambient noise reduction. More advanced models add Bluetooth or tethered connectivity, recording capabilities, enhanced controls, and other more specialized features. As you'd expect, basic models cost less, while many advanced models come with super-premium price tags.

On the design side, there's a little more diversity. Two manufacturers offer electronic models with a more traditional stethoscope feel. A mechanical headset is attached to a chestpiece – in this case, an electronic one. (This is the approach we’ve taken.) Another manufacturer offers an in-line amplifier that connects to your own scope (or one supplied by the manufacturer), allowing you to convert a legacy acoustic scope into a digital, connected one. And a third company re-thinks the design altogether. Their product looks more like something out of Star Trek than a doctor’s office. This model eliminates the traditional headset altogether and replaces it with earbuds or even over-the-ear headphones.

How to determine which model is right for you?

If any of the design types don't appeal to you, eliminate them from consideration. Then, from a functional standpoint, ask yourself, "How do I plan to use this stethoscope?"

If you:

• plan to use it for basic assessment or blood pressure measurement

If you:

• regularly perform a full auscultatory exam
• are a cardiologist or respiratory therapist
• work in a somewhat noisy environment
• are slightly hearing impaired or could use an acoustic boost

If you:

• are a researcher
• need to collaborate with other professionals and share data
• are involved in telemetry
• are a gadget geek and always go for leading edge

What are the strengths and weaknesses of each?

Here, presented alphabetically, is a synopsis of the market leaders as we see them. Keep in mind, we are the manufacturer of the Adscope 658, though we’ve tried to remain impartial in our assessments.  

Adscope 658:  The fourth-generation of our electronic scope

Strengths: Amplification is very good. Particularly helpful on higher frequencies when compared to an acoustic scope.  Clear acoustic distinction between high- and low-frequency modes. Nice appearance.   Light and comfortable. Replaceable diaphragm and traditional cardiology headset provide marked improvement over previous model (Asdscope 657).  Li-Ion battery provides long life between charges. Eight headset color options. Warranty and price best in class.  

Weaknesses:  Uses Li-Ion battery, which will need replacement every tree years or so.  Not waterproof.  Least feature-rich model available. Amplification “weakest” in class, but that assumes competitive models perform to their stated spec (which we don’t believe is always the case).

Availability:  Widely available through ADC’s worldwide dealer network including online. MSRP is $299.99, market price is closer to $239.99.

Eko Core: A digital amplifier that connects to select cardiology and clinician scopes

Strengths: Terrific Bluetooth connectivity and smart phone interface. Eventual diagnostics through the cloud. Because it is an attachment to a traditional scope it can be used in both digital and analog mode (the only one to offer this feature). Potentially the lowest price on the market if you already have a scope. Lots of good press and technology awards.

Weaknesses: Although it reports strong specs, our tests found the amplification lacking except when listening through the app and earbuds. The length and weight can be awkward. (ADC makes the accompanying scope for Eko, and they use the already heavy 601. Once you add the amplifier and extra tubing it tops 250 grams.) Need to disassemble your acoustic scope, which may void warranty and will damage tubing unless done properly. When purchased with a scope, available only in black.

Availability: Sold direct and through a handful of retailers. Sold separately ($199.99) or with an ADC-manufactured cardiology scope ($299.99).

Littmann 3100 and 3200: The undisputed leader

Strengths:  Brilliant design, solid construction. Acoustics are excellent. Only model with ambient noise reduction tech, which is very effective for eliminating the background hum found in clinical settings.  Great features and user programmability. The basic model (3100) offers amplification and ANR, while the advanced model (3200) adds Bluetooth connectivity and optional diagnostic capabilities. Three headset color options.

Weaknesses:  Not many.  A little pricey but often deeply discounted. The 3200 is overkill. I think their high-frequency performance is not as good as the Adscope 658 (it all sounds very bassy).

Availability: Widely available through Littmann’s dealer network.  MSRP ranges from $400-$600, with market prices from $350 - $450.  

Thinklabs One:  Far and away the most advanced and spec heavy

Strengths:  Well made, compact. Strong specs. Requires earbuds (supplied) or headphones, which may appeal to a younger generation of new practitioners. Lots of control over frequency, volume, etc. App compatible but the app not as clean as the Eko.

Weaknesses:  I tested the scope and at the time was not overwhelmed by the amplification. It is reported at 100X – significantly more than the Adscope 658 – but just didn’t perceive that degree of performance advantage. More control and features than are needed. Because it uses earbuds it can’t be draped around the neck like a traditional scope; at best you drop the head in your pocket then drape the earbuds around your neck. Again, new docs might be willing to embrace but most established professionals would probably prefer a more traditional design.  

Availability: Sold direct and through a handful of retailers. MSRP is over $600, and market price is $500.

What else should you consider?

Remember, regardless of the model, electronic scopes aren’t as robust as their acoustic counterparts, nor are the warranties as generous. As such, extra care must be taken during handling and use, or service costs could mount quickly. Scopes are often stolen or misplaced, so keep that in mind when shelling out for a $200+ purchase.  

Finally, because stethoscope selection is among the most personal of choices and electronic scopes are expensive, we encourage you to test models before making a purchase.  One person’s “meat” is another’s potatoes, so try ‘em before you buy ‘em. Contrary to the advice I give on acoustic scopes where I encourage you to buy the best you can afford, with electronic scopes I recommend you don’t overbuy. If you don’t need connectivity, don’t pay for it. If you do, don’t buy one without it.  

And if you’re buying online make sure there are generous return policies in case it doesn’t live up to your expectations or meet your needs.  

Good luck!