Smart Stethoscope Helps Monitor And Diagnose Respiratory Conditions: Interview With Helena Binetskay

LungPass, an AI-powered Bluetooth stethoscope has been developed by Healthy Networks, a company based in Talinn, Estonia. The device can analyze sounds from the lungs and help to diagnose or monitor a variety of respiratory conditions, with an initial focus on pneumonia and COPD.

The aim was to create a low-cost (the device costs as little as €89 ($105)) technology that people could keep at home and use if they suspect to be were a respiratory illness or to monitor a pre-existing condition. With many respiratory illnesses, such as pneumonia, timely diagnosis and intervention is critical to avoid serious illness or death.

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Having a system that allows patients to assess their own condition could be hugely valuable in this field. However, the stethoscope could also assist clinicians in identifying respiratory illnesses, as detecting and correctly spotting the subtle sounds of respiratory disease can be tricky when using a regular stethoscope.

See a video about the technology below.

Medgadget had the opportunity to speak with Helena Binetskaya, CEO and co-founder of Healthy Networks, about the technology.​

Conn Hastings, Medgadget: What inspired you to get involved in this area?

Helena Binetskaya, Healthy Networks: Healthy Networks originated from a personal story. Four years ago, my young daughter, Yaroslava, had a severe cough for weeks. Of course, we were worried about the cause and that it might be dangerous. Every week, we would take her to a doctor, who would ask about her symptoms and listen to her lungs. Yet he repeatedly assured us that her lungs were clear and that there was no cause for worry. I scolded myself for unnecessarily exposing a child to a clinical environment, but the fear of missing a dangerous condition like pneumonia was far too great.

Then I thought: can I mimic a chest exam from home? I could get a digital stethoscope to record her lung sounds and send those over to a physician together with her symptoms, temperature, and other vitals. As it turned out there were digital stethoscopes available for US$150 – 250, but at the time I couldn’t afford it.

The fourth time I took her to a clinic, the doctor heard some abnormal sounds in her lungs, and given the history of her symptoms, prescribed a rather lengthy list of medications. We went to a pulmonologist for a second opinion, who reported that her lungs were perfectly clear and that she didn’t require treatment. Yaroslava’s cough went away after a few days and she has been perfectly healthy ever since.

This experience begged the question: if lung auscultation can impact diagnosis and treatment, but there is a problem with its accuracy and objectivity – could artificial auscultation make a difference in patient journey? This question ultimately led to the founding of Healthy Networks and our LungPass technology.

Medgadget: Please give us an overview of the societal and personal consequences of respiratory illness.

Helena Binetskaya: We often don’t think about our ability to breath, or we take it for granted. COVID aside, respiratory diseases are among the leading causes of death and disability in the world. The youngest and the oldest of our populations – our children and our parents – are the most vulnerable.

Pneumonia fills air sacs within the lungs with fluid, preventing oxygen from being delivered into the bloodstream. It is the leading infectious cause of death among children, taking 850,000 lives each year and often results in an increased risk of children developing chronic conditions. For adults, it is one of the most common causes of hospitalization. Even if a person fully recovers, there are typically long-term consequences, such as cognitive decline, worsened mobility, and cardiovascular disease. The direct medical cost alone has been estimated to be at least $17 billion in the U.S. and €10 billion in the EU.

Chronic non-infectious diseases pose the largest socio-economic burden. Chronic obstructive pulmonary disease (COPD) takes the lives of 3.2 million people each year, with one out of every five smokers developing the disease. COPD destroys the lung’s air sacs and narrows the bronchial tubes, leading to mucus buildup. For over 150 million people diagnosed with the disease, breathing becomes a struggle and greatly affects quality of life. It is one of the most expensive medical conditions, accounting for over $35 billion in the U.S. and €20 billion in the EU, with a large proportion of those costs due to hospitalizations. There are currently no cures for COPD.

Medgadget: How are respiratory conditions currently diagnosed and monitored, and what are the limitations associated with this?

Helena Binetskaya: Timely diagnosis and initiation of appropriate therapy is crucial to treating pneumonia, as it reduces the risk of complications and mortality. Chest X-Rays have been the gold standard in diagnosis. While available in hospitals, X-Rays are often inaccessible at the primary care level or require a certain waiting period. The same limitations exist for patients trying to access advanced blood tests. General practitioners rely on a clinical picture, medical history, and physical exam of a patient to determine the probability of pneumonia. Unfortunately, such assessments are often not sufficient. Over 40% of pneumonia cases are missed at first presentation to a practitioner.

The most common method for COPD diagnosis is spirometry. While it is a highly effective test, the problem arises with disease management. Today, there are simply no objective tools that would allow people with COPD to monitor the progression of their disease and detect an exacerbation, or severe worsening of symptoms, in time. People are forced to rely on self-assessment of constantly present and fluctuating symptoms. This results in up to 70% of life-threatening COPD exacerbations being reported late by patients, which in turn leads to preventable hospitalizations, decreased quality of life, and mortality.

Medgadget: So how does the LungPass technology work? Please give us an overview of the hardware and software components.

Helena Binetskaya: Our product, LungPass, is the world’s first low-cost ANN-powered app and Bluetooth stethoscope for lungs. It turns lung sounds into objective early biomarkers of deadly lung conditions. The core technology has been built upon a large dataset of lung sounds labelled by a panel of professors in the respiratory field.

Within the app, a person is given instructions on how to record lung sounds using the stethoscope. The number of required recordings varies depending on each patient’s history and individual medical condition, with the maximum being 11, with each lasting five seconds. Upon completion the app will let the individual know what specific types of sounds were detected and their meaning. The app also asks to log symptoms to get a full clinical picture. As a result, the most probable condition affecting that individual is presented.

By dedicating only a few minutes per check-up each day, anyone can self-monitor progression and detect a deterioration of a respiratory condition from their home.

Medgadget: What conditions can the system be used to identify or monitor?

Helena Binetskaya: The system has the potential to be used to identify or monitor any respiratory condition that is characterized by certain lung sounds – asthma, COPD, bronchitis, IPF, pneumonia. There are also useful applications for this technology during anesthesia.

Our initial focus is in pneumonia and COPD. In an ongoing feasibility study, LungPass successfully detected pneumonia in 95% of 148 patients by detecting a crackling sound in the lungs – a strong independent predictor of the disease. This is especially significant as past studies have demonstrated that crackles are one of the most fleeting lung sounds, and easily missed by a human ear.

Another study that examined a cohort of 30 self-monitoring COPD patients found that although only a number of them exacerbated during the study, we observed consistent pattern across various COPD stages of sound change two to three days prior to symptoms change and seven days prior to hospitalization. The practical implication is in the timely step up in therapy, which, according to literature, may reduce COPD hospitalizations by over 30%.

Medgadget: How do you envisage that the technology would be typically used? Is this something that is primarily for home use or for use by clinicians?

Helena Binetskaya: LungPass is intended to be used both at home and by front-line healthcare professionals to prevent unnecessary visits to the doctor while simultaneously facilitating timely initiation for critical conditions.

LungPass provides the user with clear information that suggests whether a respiratory condition is dangerous or not based on the sound and symptoms registered. We envision the system being as commonplace as the thermometer and something that every family can have in their medicine cabinet.

When used by a general practitioner or a nurse, LungPass serves as a second pair of ears, enabling the user to pick up the telltale sounds of disease in the same way a pulmonologist with dozens of years of experience would.

In both cases, it enables timely intervention that leads to the reduction of hospitalizations, improved outcomes, and decreased cost.

Medgadget: When do you envisage that the system will be available?

Helena Binetskaya: We launch sales in CIS in two weeks and anticipate CE mark approval in the very near future, with commercialization in Europe early next year. We’re heavily focused on finding the most seamless way to integrate LungPass into the regular healthcare practice, starting in Germany.

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