Deep learning diagnostic and risk-stratification pattern detection for COVID-19 in digital lung auscultations: clinical protocol for a case–control and prospective cohort study

BMC Pulmonary Medicine

Véronique Trombert¹  Stéphane Bourquin²  Johan N. Siebert³  Aymeric Cantais³  Alban Glangetas³  Alain Gervaix³  Hervé Spechbach⁴  David Rivollet⁵  Alexandre Perez⁶  Martin Jaggi⁷  Deeksha M. Shama⁷  Mary-Anne Hartley⁷  Constance Barazzone-Argiroffo⁸  Delphine S. Courvoisier⁹ 

[1] Department of Internal Medicine and Rehabilitation, Geneva University Hospitals, Geneva, Switzerland;Department of Micro-Engineering, Geneva School of Engineering, Architecture and Landscape (HEPIA), Geneva, Switzerland;Division of Paediatric Emergency Medicine, Department of Women, Child and Adolescent, Geneva University Hospitals, 47 Avenue de la Roseraie, 1205, Geneva, Switzerland;Division of Primary Care Medicine, Department of Community Medicine, Geneva University Hospitals, Geneva, Switzerland;Essential Tech Centre, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland;Geneva University Hospitals, Geneva, Switzerland;Intelligent Global Health, Machine Learning and Optimization (MLO) Laboratory, Swiss Federal Institute of Technology (EPFL), Lausanne, Switzerland;Paediatric Pulmonology Unit, Department of Women, Child and Adolescent, University Hospitals of Geneva, Geneva, Switzerland;Quality of Care Unit, Geneva University Hospitals, Geneva, Switzerland;

关键词: COVID-19;    Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2);    Deep learning;    Artificial intelligence;    Respiratory sounds;    Auscultation;    Pneumonia;   

DOI  :  10.1186/s12890-021-01467-w

来源: Springer

【 摘 要 】

BackgroundLung auscultation is fundamental to the clinical diagnosis of respiratory disease. However, auscultation is a subjective practice and interpretations vary widely between users. The digitization of auscultation acquisition and interpretation is a particularly promising strategy for diagnosing and monitoring infectious diseases such as Coronavirus-19 disease (COVID-19) where automated analyses could help decentralise care and better inform decision-making in telemedicine. This protocol describes the standardised collection of lung auscultations in COVID-19 triage sites and a deep learning approach to diagnostic and prognostic modelling for future incorporation into an intelligent autonomous stethoscope benchmarked against human expert interpretation.MethodsA total of 1000 consecutive, patients aged ≥ 16 years and meeting COVID-19 testing criteria will be recruited at screening sites and amongst inpatients of the internal medicine department at the Geneva University Hospitals, starting from October 2020. COVID-19 is diagnosed by RT-PCR on a nasopharyngeal swab and COVID-positive patients are followed up until outcome (i.e., discharge, hospitalisation, intubation and/or death). At inclusion, demographic and clinical data are collected, such as age, sex, medical history, and signs and symptoms of the current episode. Additionally, lung auscultation will be recorded with a digital stethoscope at 6 thoracic sites in each patient. A deep learning algorithm (DeepBreath) using a Convolutional Neural Network (CNN) and Support Vector Machine classifier will be trained on these audio recordings to derive an automated prediction of diagnostic (COVID positive vs negative) and risk stratification categories (mild to severe). The performance of this model will be compared to a human prediction baseline on a random subset of lung sounds, where blinded physicians are asked to classify the audios into the same categories.DiscussionThis approach has broad potential to standardise the evaluation of lung auscultation in COVID-19 at various levels of healthcare, especially in the context of decentralised triage and monitoring.Trial registration: PB_2016-00500, SwissEthics. Registered on 6 April 2020.

【 授权许可】

CC BY