The Mayo Clinic is launching an mHealth project to determine whether a digital stethoscope can be used to screen for damaged hearts.
The health system is teaming up with Eko to test the Silicon Valley company’s DUO Digital Stethoscope on patients diagnosed with asymptomatic left-ventricular dysfunction. The goal is to see whether the connected care platform, which tracks acoustic data and creates a single-lead electrocardiogram, can detect low ejection fraction, which occurs when a compromised heart changes its patterns to function normally.
To do this, Mayo researchers are pairing the telemedicine platform with the health system’s electronic health record platform and AI tools. They’ll be matching new data collected by the digital health device with data collected by the health system and using machine learning algorithms to connect the dots.
“You have these pairs of ECGs and echoes,” Dr. Paul Friedman, the Mayo Clinic’s chairman of cardiovascular medicine, recently told the Minneapolis Star Tribune. “The echo is the expensive test and the ‘right’ answer, so to speak. And then we have the ECG, which is the inexpensive and ubiquitous test. And we want to train the computer to read the ECG. So we say, here’s the ECG (from the old medical record) and here’s the right answer. And each time we do that, it is learning the little individual characteristics.”
Friedman said the process produced 86 percent accuracy in an as-yet-unpublished test that was featured at an American College of Cardiology conference this past March. In that test, the health system screened 45,000 ECGs and echoes collected from past patients and flagged 1,300 instances where an echo didn’t show signs of stress but an ECG did.
“So the heart muscles are having some electrical problem that is subtle that the ECG is picking up, but it’s so early that the heart pump is still strong,” Friedman told the newspaper. “It’s detecting (heightened risk) before the echo even shows a weak heart pump.”
The Mayo Clinic project demonstrates how healthcare is looking to expand the reach of connected health platforms to new uses, often by integrating with EHR platforms and other technology. The process may be best exemplified in the diabetes technology space, where platforms that once focused solely on remote testing for blood glucose levels are now incorporating AI and other technologies for health and wellness and even care management for other chronic conditions.
One caveat: Each new use requires not only clinical validation by federal approval. Eko’s digital stethoscope has been approved by the US Food and Drug Administration for its traditional stethoscope-related function, but would need new FDA approval should the Mayo Clinic project prove successful.
Earlier this month at the American Heart Association’s Scientific Sessions 2018, researchers unveiled a study in which Eko’s digital health platform, combined with AI tools, performed better at detecting heart murmurs in pediatric patients than typical office-based tests.
“When it comes to healthcare, data almost always leads to better results because practitioners are able to make more informed decisions,” Dr. Nicholas Slamon, a Pediatric Critical Care Physician at Nemours Children’s Health System, said in a release supplied by Eko. “Eko’s technology is leveraging the largest available dataset of previously captured heart sounds to elevate the skills of clinicians and in turn provide guidance on how to diagnose, and subsequently treat, serious, often fatal cardiac conditions. It’s a powerful advancement for the world of medicine.”
With the Mayo Clinic partnership, healthcare providers are now training the technology on a new challenge – one that affects millions of Americans. A mobile health tool that diagnoses that condition earlier could lead to earlier and better treatment plans that improve outcomes and reduce the rate of serious health issues.
“With this collaboration we hope to transform the stethoscope in the pocket of every physician and nurse from a hand tool to a power tool,” Friedman said in a press release. “The community practitioner performing high school sports physicals and the surgeon about to operate may be able to seamlessly tap the knowledge of an experienced cardiologist to determine if a weak heart pump is present simply by putting a stethoscope on a person’s chest for a few seconds.”