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Is it pneumonia? Now there’s an app for that

Jocelyn Wright

| 16 May, 2017 | 1 comments Read Later
A smartphone app that listens to the sound of child’s coughs might assist in diagnosis of respiratory infections and help curb antibiotic use, researchers say.
Although the tool is expected to be most useful in low-resource countries, it may help doctors in Australia distinguish between upper and lower respiratory tract infections, sparing reliance on X-rays in children.
The app, which is currently titled ResAppDX, is the brainchild of the University of Queensland’s Associate Professor Udantha Abeyratne, and has been tested by researchers at Princess Margaret Hospital in Perth.
In a study of 379 Australian children, presented at the recent Royal Australasian College of Physicians’ annual conference, the app distinguished between children with upper and lower respiratory tract infections, with 88% sensitivity and 83% specificity.
Investigator Dr Jamie Tan, a respiratory physician, said the app shows “significant promise” as a diagnostic tool for use in lower-income settings like Indonesia, where it was first piloted.
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But it could also be developed for use in developed countries in telehealth consultation, triage settings, nursing clinics, and in assessing asthma severity.
The app's algorithm works by recognising patterns in sound signatures and learning from the cough data it collects.
“Different organisms — viral pneumonia versus a bacterial pneumonia — cause different changes in the lungs and airways, and so the inflammation and secretions do change the sounds that are produced,” Dr Tan said.
“When we listen with a stethoscope, we have to listen through layers of muscle and chest wall tissue, whereas when you cough, your glottis opens and you’ve essentially got what an amounts to a continuous column of air between your lower airways and the outside world,” he said.
Preliminary data suggested the algorithm might be better at detecting signs of lower respiratory infection than a clinician with a stethoscope.
“We suspect that some of the inaccuracy in our study is due to patients who were diagnosed clinically as having a clear chest on a stethoscope exam and therefore diagnosed with an upper respiratory tract infection, but actually had some lower respiratory involvement, which the algorithm detected,” Dr Tan said.
The technology was recently licensed by ResApp Health, which plans to partner with Doctors Without Borders to validate the tool in lower-income and rural settings.
Dr Tan said the app technology could help in the battle against antimicrobial resistance by limiting the use of antibiotics for viral pneumonia.
“In a country like Australia ... I’m not sure if it would replace [usual diagnostic methods], but certainly there’s a case to be made you could reduce the reliance on X-rays for children with coughs,” he said.
More Information:
Journal of Paediatrics and Child Health 2017; online.