Dr Pierre Viviers and colleagues from the Institute of Sport and Exercise Medicine (ISEM) won the prestigious David Sisk Award for Best International Paper for the official journal of the American Orthopaedic Association.

Their paper, entitled: “The Diagnostic Utility of Computer-Assisted Auscultation for the Early Detection of Cardiac Murmurs of Structural Origin in the Periodic Health Evaluation" relates to a home-grown computer-driven clinical auscultation device. An auscultation device is a device which listens to the internal sounds of the body to examine the circulatory, respiratory and gastrointestinal systems.

The T. David Sisk Research Awards were established in 2010 to honour the best papers submitted to Sports Health: A Multidisciplinary Approach in clinical, laboratory, and international research.  The winners receive a $2,500 cash prize and a plaque.
 
Sisk, who died in 2009, was a staunch advocate of a multidisciplinary approach to sports health and left a strong legacy of teaching and collaboration. He served as the chairman of the American Orthopaedic Society for Sports Medicine (AOSSM) Medical Publishing Board of Trustees at the time when the creation of the new journal was proposed.  

In an interview, Viviers, who is the head of Campus Health Services at Stellenbosch University as well as being associated with ISEM, said the paper provides sports physicians with a tool to assist in decision-making when cardiac murmurs are present in athletes.

“It is challenging to identify the nature of cardiac murmurs during the periodic health evaluations of athletes because of the difficulty in distinguishing between murmurs of physiological or structural origin. Computer-assisted auscultation (CAA) has, previously, shown promise in supporting appropriate referrals in the non-athlete paediatric population. Our hypothesis was that CAA could have the ability to accurately detect cardiac murmurs of a structural origin doing a periodic health examination in university athletes."

The study, which used a total of 131 university athletes, concluded that CAA could potentially improve the identification of structural murmurs in athletes. However, more research is needed.

“Our award came as a surprise. I did not imagine we would win," he said. “The competition is quite extensive to get in. We put a lot of heads together to develop the study protocol for this – so I can put our success down to teamwork. We are very happy that our project ended in a significant way."

Viviers won the award wearing his ISEM hat and collaborated with fellow ISEM colleagues, Professor Wayne Derman, director of ISEM; Dr Joann Kirby, a sports physician in campus health service and Jeandre Viljoen, a physiotherapist and MA student in physiological sciences.

“The project started when we read in the Innovus monthly newsletter about a technology company working in the biomedical engineering sphere that was working on developing an electronic stethoscope for use in rural areas. The idea was that nurses and doctors in those areas could use it to diagnose structural heart pathologies, valve lesions and other cases, so that they can refer the patients further.

“We contacted the project manager and decided to work on the project.

“What interested me was the fact that in athletes you often hear murmurs because of the physiological changes that occur in the heart during exercise, but obviously underlying conditions can also produce murmurs. It is sometimes difficult to distinguish between a normal non-structural lesion in athletes and a real problem.

“So, I thought there might be some interest to look into this. We then wrote a research proposal and got ethical approval and started our research using university athletes.

“We pitched our pilot study when it was the time of year when we do health screenings with high-performance athletes. We did a pilot study and then published our data."

Asked what the award means to him, Viviers said: “It means there is definitely a place for pre-participating screening in athletes. We have recommended that further studies take place with more numbers. We believe this tool will assist physicians in the evaluation and decision making in the presence of murmurs in athletes."

Caption: Dr Pierre Viviers (middle) receiving the David Sisk Award for Best International Paper from members of the American Orthopaedic Society of Sports Medicine.