Artificial intelligence enabled Stethoscope(StethoMe) ,when applied to chest,records both continuous sound like wheeze and non continuous sound like crackles. It also records heart rate and respiratory rate. It then transfers the data wirelessly to mobile app enabled with Artificial Intelligence(AI) ,which analyzes it and gives the report. It also gives the ratio of duration of inspiration to expiration(I:E) which is an important parameter for detection of asthma exacerbation.
StethoMe is CE Certified Class 11a medical device,and AI has been trained after recording of more than 10000 respiratory sounds.
In a study published in Annals of family medicine, 52 children in which 63.5% were male, ,between the age of 0-5 years,38 children in which 76.3% were male between the age of 6 to 17 years, and 59 adults in which 27.1% were male were enrolled.
They were given StethoMe and in addition to it ,they were also given Pulse oximeter and Peak flow meter(For PEF monitoring).
All participants performed the examination,one time, daily with the device thirty minutes after taking regular asthma medication as a controller for first 14 days then at least once in a week.
They performed the examination twice daily during the period of felt exacerbation in the form of increased symptoms.
Participants performed 6442 complete examinations and they produced 41872 recordings.
6.4% participants were excluded from the study as they did not meet the quality criteria.
A total of 17 physicians,2 from internal medicine,4 Pulmonologists,9 Pediatricians,5 Allergologists,and 4 family medicine specialists analyzed the data in which few of them were having double specializations.
Researchers obtained ROC(Researchers operating characteristic) and AUC (Area under curve)
Among young children the best discriminator for exacerbation was wheeze intensity with an AUC of 84% (95% CI, 82%-85%).
Among older children the best discriminator was ronchi intensity with AUC of 81% (95% CI, 79%-84%)
Accordinng to GINA guideline, the diagnosis of asthma exacerbation in children should be based on subjective symptoms but the symptoms reported by care givers in this age group is not sufficient for the diagnosis of excerbation or exclusion of exacerbation with an AUC of 72% (95% CI, 70.1%-73.9% as per the research.
The data provided by StethoMe along with Peak flow meter and SpO2 was the best for assessment of asthma exacerbation in all age groups.
CONCLUSION:The data provided by StethoMe-respiratory sounds,heart rate,inspiratory and expiratory ratio enabled with AI is very useful without PEF in detecting Asthma exacerbation specially in children below 5 years of age
REFERENCES:: Emeryk A, et al. Ann Fam Med. 2023;doi:10.1370/afm.3039.
Dr Deo Kumar Jha,M.D., Child and Child Chest Specialist,Ghaziabad, Delhi and NCR