AI stethoscope trial shows promise for early heart disease detection

Large UK trial shows the AI-enabled stethoscope can detect heart failure, atrial fibrillation and valve disease in advance, but experts caution it still needs better integration into medical practices

The stethoscope has long been a symbol of medicine and healthcare professionals. Now it is entering the digital age.

 

Researchers at Imperial College London and the Imperial College Healthcare NHS Trust in London have conducted a study using an artificial intelligence (AI)-enabled stethoscope and found it can spot heart failure, heart valve disease and abnormal heart rhythms almost instantly.

This smart tool uses a microphone to analyse subtle differences in heartbeat and blood flow that the human ear cannot detect.

 

How it works: Sound, ECG and AI

This smart stethoscope, developed by US-based Eko Health, performs dual functions. It captures heart sounds (a phonocardiogram) via a sensitive microphone array, and simultaneously records a single-lead ECG (Electrocardiogram). The data is sent to the cloud for AI analysis, with results being delivered to a smartphone. The AI has been trained using data from thousands of existing patients.

 

A separate algorithm can detect atrial fibrillation, which often has no symptoms, but can be managed with blood-thinning medications. 

Clinical trial results

The study, called TRICORDER (Triple cardiovascular disease detection with an artificial intelligence-enabled stethoscope), involved more than 200 primary care practices across London, covering a population of around 1.5 million people. Over 12,700 patients with symptoms such as breathlessness, fatigue or swollen legs were examined using the AI stethoscope. Their results were then compared with patients at practices that did not use the device.

 

The trial showed:

 

1) People examined with AI stethoscope were 2.33 times more likely to be diagnosed with heart failure within 12 months

 

2) They were 3.45 times more likely to be diagnosed with atrial fibrillation

 

3) They were 1.92 times more likely to be diagnosed with heart valve disease

 

However, after 12 months, around 70 per cent of the practices stopped using the smart stethoscopes regularly. Researchers said the devices will need to be better integrated into doctors’ daily routines if they are to be widely adopted.

 

The study found that about two-thirds of patients flagged by the AI stethoscope for suspected heart failure were later cleared after further tests, such as blood work or heart scans.

 

Early treatment with early diagnosis

Heart failure is often diagnosed late, typically when patients arrive in emergency settings already unwell, making early detection vital.

 

Dr Sonya Babu-Narayan, clinical director at the British Heart Foundation (BHF) and Consultant Cardiologist, said the innovation was “an elegant example of how the humble stethoscope, invented more than 200 years ago, can be upgraded for the 21st century”. She said such advances are vital, because “so often heart conditions are only diagnosed at an advanced stage when patients attend hospital as an emergency”. With earlier diagnosis, she explained, people can access the treatment they need to help them live well for longer.

 

Prof Mike Lewis, scientific director for innovation at National Institute for Health and Care Research, said, “This tool could be a real gamechanger for patients, bringing innovation directly into the hands of GPs (general practitioners). The AI stethoscope gives local clinicians the ability to spot problems earlier, diagnose patients in the community, and address some of the big killers in society.”

 

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