Imagine a stethoscope detecting heart disease just by placing it on the chest. In November 2023, the UK National Health Service (NHS) rolled out a countrywide trial where they provided general physicians with artificial intelligence-enabled smart stethoscopes to understand if it would help improve diagnosis for heart failure and reduce overall costs.
As part of the trial, a collaboration between Imperial College London, NHS North West London Integrated Care System and Betsi Cadwaladr University Health Board, the Eko DUO device, a smart stethoscope, is being deployed across 100 primary care centers across North West London and North Wales to be used by clinicians.
Heart failure, also known as congestive heart failure, is a condition in which one’s heart is unable to pump blood effectively, as per the body’s requirements. Titled the TRICORDER programme, the trial will allocate more than three million random patients to either receive the smart telescope or continue with their current care.
Role of stethoscope
Right from the time the stethoscope was introduced, it has been primarily used to detect the sounds of the heart, the lungs, and the abdomen, says Dr Adil Sadiq, senior consultant cardiothoracic and vascular surgeon, Sakra Hospital, Bangalore.
“The stethoscope is crucial in diagnosing any heart disease. Often, critical heart conditions, such as murmurs and the presence of a hole in the heart and its location, can be heard and identified with a stethoscope. We can distinguish between various diseases, including the sounds of the heart valves and which of the four valves are affected, just by hearing the sound,” he said.
Dr Sadiq added that learning to interpret sounds through a stethoscope is a process that comes with experience. One must learn to recognize these sounds to effectively identify them.
How can an AI stethoscope help?
Dr Sadiq says that with artificial intelligence, we can hear the sound clearly which is further amplified for better detection. “It gives a phonographic record of the sound, which is similar to music, which has waves that come in depending upon the frequency. AI will be able to track these changes and map the phonographic sound of the heart, which also gives a reasonably accurate diagnosis,” he said.
Professor Nicholas Peters, consultant cardiologist at Imperial College Healthcare NHS Trust, while speaking about the initiative in a statement, said, “Heart failure admission alone costs the UK over £2 billion annually, and an unacceptable 80 percent of these diagnoses are made during emergency admissions.”
The NHS stated in the release that 80 per cent of patients are diagnosed with heart failure late after they spend a lot of time undergoing several medical tests. It emphasized that an early diagnosis will reduce costs, enhance the effectiveness of treatments and improve symptoms, quality of life, and survival.
Co-investigators Dr Patrik Bächtiger and Dr Mihir Kelshiker, from Imperial College London and Imperial College Healthcare NHS Trust, said, “TRICORDER is a system-wide implementation of Eko’s clinically effective AI technology. Implementing this tool in primary care could save the health payer system £2,400 per patient, eliminating the potential need for an emergency room visit.”
According to the NHS, the device, when it was tried on patients at the same Healthcare, was able to test for heart failure with a 91 per cent sensitivity and 80 per cent specificity, compared to the invasive, traditional tests, which are also highly-priced.
With more data, AI can diagnose efficiently: Experts
Dr Rahul Chandola, founder-chairman and chief of cardiothoracic surgery, Institute of Heart Lungs Diseases Research Centre (IHLD), speaking about the future of AI stethoscopes in diagnosis, says that today, AI has been well integrated into almost all the specialties and all the fields — be it the therapeutic or diagnostic medical branches.
“With AI, processes have become so streamlined that one simply needs to analyze the pattern,” he says.
Explaining further, Dr Chandola illustrates: “For instance, if there’s a cardiac lesion, what we recognize is a specific sound that our ears have been trained to pick. If AI is fed with this data from millions of people, it can precisely pinpoint the diagnosis,” he says.
According to Dr Sadiq, the AI stethoscope is a boon for people in remote areas, especially for doctors like cardiologists, specialists and general physicians who don’t have access to echocardiograms or an echo machine or echo technicians to manage the machines. It will help in the diagnosis of certain conditions related to the heart and lungs.
“The accuracy is also higher in AI stethoscopes and can overtake the human experience. If AI is being fed with the relevant data, it has more predictive capabilities,” says Dr Chandola.
Dr Sadiq said that people end up spending a lot of time and money in getting their diagnoses right. Through this device, it can be saved. “This will help in fastening the process and meeting the specialists in time for treatment,” he said.
Takeaway
The UK NHS has rolled out artificial intelligence-powered smart stethoscopes in 100 primary care facilities countrywide, to evaluate if it can help in the early diagnosis of heart failure, a condition in which the heart is not able to pump sufficient blood.
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