Millions of people worldwide suffer from
chronic lung conditions that require regular, careful monitoring.
The severity
of these diseases is usually measured using spirometers - devices that measure
patient lung function.
Traditionally, this was only conducted in clinical settings, but
home spirometry is gaining acceptance in the medical community due to its
ability to detect pulmonary exacerbations and improve outcomes of chronic lung
ailments. However, cost and usability are often significant barriers to its
widespread adoption.
Now, a new health-sensing tool has been developed by a team of
computer science and engineering and electrical engineering researchers - from
the University of Washington (UW) - that can accurately measure lung function
over a simple phone call.
Most people in the
developing world who have asthma, cystic fibrosis, or other chronic lung diseases
have no way to measure how well their lungs are functioning outside of a clinic
or doctor visit.
The new service, called SpiroCall, allows patients to perform
spirometry on any phone. The patients take a deep breath in and exhale as hard
and fast as they can until they cannot exhale any more.
The phone's microphone senses
sound and pressure from that exhalation and sends the data to a central server,
which uses machine learning algorithms to convert the data into standard
measurements of lung function. The server computes the lung function
measurements and sends the patients a response.
"We wanted to be able to measure lung function on any type
of phone you might encounter around the world - smartphones, dumb phones,
landlines, pay phones," says Shwetak Patel, Washington research foundation
endowed professor of computer science and engineering and electrical
Engineering at UW.
"With SpiroCall, you can call a 1-800 number, blow into the
phone and use the telephone network to test your lung function."
Meeting the need for
at-home lung-monitoring devices
The SpiroCall solution builds upon earlier work by the team that
involved developing a smartphone app called SpiroSmart.
Introduced in 2012, the original application records the user's
exhalation and sends the audio data generated to a central server. The server
then calculates the expiratory flow rate using a physiological model of the
vocal tract and a model of the reverberation of sound around the user's head.
The development of the SpiroSmart technology was an important
step in making spirometry more accessible, and since its introduction, it has
been involved in numerous clinical studies and is currently deployed in
multiple locations around the world, including Seattle and Tacoma in the United
States, Khulna in Bangladesh, and Pune in India.
Over the last 4 years, the team has collected data from more
than 4,000 patients, where clinicians have measured lung function using both
SpiroSmart and a commercial spirometer.
That comparative data has improved the performance of the
machine learning algorithms and laid the groundwork for team's current Food and
Drug Administration (FDA) clearance process.
New tool meets medical
community's accuracy standards
In a recent paper, the team documented results from
the new solution that came within 6.2 percent of results from clinical
spirometers used in hospitals and doctor's offices, meaning it meets the
medical community's standards for accuracy.
Using a smartphone app presented a number of challenges when it
came to deploying the solution in many developing regions of the world that
could really benefit from this type of technology.
Lack of accessibility to smartphone technology alongside the
need to recalibrate the software algorithms to work with different handsets and
devices meant that widespread adoption and deployment was problematic.
The new solution solves many of
these issues. By using any phone, from a shared landline to a 10-year old
mobile phone, the technology can now benefit anyone with access to any phone
service.
When developing the call-in solution, the team needed to
overcome problems with sound quality. But by combining multiple regression
algorithms, they were able to provide reliable lung function estimates despite
the degraded audio quality.
"We had to account for the fact that the sound quality you
get over a phone line is worse," said co-author Elliot Saba, a UW
electrical engineering doctoral student. "You can imagine how listening to
someone play a song over a phone line would sound compared to listening to it
on your music app - there's a similar difference with a spirometry test."
The researchers hope that the success of the project, so far,
will enable them to improve access to home-based spirometry and lung function
monitoring and in turn improve the way care is administered to patients around
the world.
"Our research area is not just about sensing, but
human-centered sensing," Goel said. "Because this project has been
around for 4 years, we've been able to talk to a lot of patients about how
they're able to use the technology, and that feedback has really helped us make
smart improvements."
Source:
medicalnewstoday
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