Stethoscopes enabled with artificial intelligence (AI) technology are to be deployed to primary care practices to evaluate whether they can assist GPs to increase early detection of heart failure for patients, reduce diagnosis through emergency hospital admission, and reduce costs for the NHS.
A total of 100 GP practices will receive the Eko DUO (Eko Health) device as part of a project called TRICORDER, named after the fictional medical diagnostic scanner from the TV series Star Trek.
The project is led by researchers at Imperial College London (ICL) and funded by a £1.2 million award from the National Institute for Health and Care Research. Professor Nicholas Peters, from ICL's National Heart and Lung Institute, and Imperial College Healthcare NHS Trust, said, "Heart failure admission alone costs the UK over £2 billion annually, and an unacceptable 80% of these diagnoses are made during emergency admissions."
Co-investigators Dr Patrik Bächtiger and Dr Mihir Kelshiker, also from ICL, highlighted that there were no accurate or easily used tools to aid GPs in checking for heart failure. "If they suspect a patient may have heart failure, patients may go through a long and rarely completed pathway to diagnosis," they explained.
The researchers also pointed out that 80% of heart failure is currently diagnosed in hospital, despite 40% of patients having symptoms that should have triggered an earlier assessment.
Positive Results From Previous Trial
In a previous study, published in The Lancet Digital Health in January 2022, the researchers reported positive diagnostic results from combining a novel AI algorithm with the commercially available ECG-enabled Eko DUO. The AI tool demonstrated high levels of sensitivity (91%) and specificity (80%) and compared favourably with routine diagnostic tests that were "invasive and expensive", they said.
"A deep learning system applied to single-lead ECGs acquired during a routine examination with an ECG-enabled stethoscope can detect LVEF of 40% or lower," the study authors concluded.
For the latest trial, 200 GP practices across Northwest London and North Wales will randomly be allocated to receive an AI-enabled stethoscope or continue with usual care for patients.
Patients visiting a GP equipped with the AI stethoscope would receive a brief, noninvasive heart examination using the tool. If the device detected possible signs of cardiac disease, the GP could rapidly start further tests and treatment. Patients who attended GP clinics not using the AI tool would continue to receive typical care for detection and treatment of heart failure.
The widespread use of AI tools in primary care has the potential to improve heart disease outcomes for millions of people in the UK, according to the researchers, who said it could also save the NHS time and money through early diagnosis and treatment.
"Implementing this tool in primary care could save the health payer system £2400 per patient, eliminating the potential need for an emergency room visit," predicted Drs Bächtiger and Kelshiker.