Many physicians will tell you they prefer the Sprague Rappaport for good sound. But it is too bulky to carry in your pocket. The Littman's are easy to carry, but the sound is not as good. The electronics are rarely carried by cardiologists. No substitute for the old fashioned method.
I have to be honest with you here, as a nurse I can honestly tell you that I have never ever seen a real doctor carry a Sprague. Most docs think they are somewhat childish, meaning not child like, but rather used by people who really don't know what they are doing, or who are "young" to the medical profession, with all due respect, and no offense intended.
I have used them a time or two when I didn't have my own, and yes, to a very untrained ear, with all due respect, or to a layman, again with all due respect, it appears that they have excellent sound because what you hear is loud which makes it seem like it's the better scope.
However most medical professionals will tell you that a loud sound doesn't mean a better sound. The sprague's sound is sort of staticy, and that's not really what I am meaning to say, but not quite sure how else to describe it exactly. It's sort of muffled maybe. A Littman may not be as loud sometimes but the quality of sound that you are hearing is much clearer, and to a medical professional, it's not at all about volume, it's about clarity.
Besides that, the Spragues are way too bulky and way too heavy. Another factor here is that a lot of the Spragues have double tubing which is also not ideal, that fact alone cuts it way down in the class of the other scopes actually.
I happen to have an electric Littman that is the envy of all my co-workers, including the doctors who are constantly wanting to borrow it. It's top of the line and provides superior sound and clarity. My doctor/boyfriend uses an electric Thinklabs scope which he also loves and it also provides great sound and clarity, however you do get what you pay for as his was about 300 bucks and mine was closer to 500. Needless to say, the Rappaport Spragues are, according to my nursing catalogues, 12.99. Just sayin.
Just my medical opinion.
Mashie