The home remote diagnostics of bronchial asthma in children with the using of telemedical system
Sergey Malinin, Е. Г. Фурман, Elena Rocheva, Vladimir Sokolovsky, G. B. Furman · 2019
Background: To develop a tool for independent objective auscultation of the lungs and diagnosis of bronchial asthma at the home, the telemedicine system has been improved. Objectives: Assess the effectiveness of an improved telemedicine system for the diagnosis of asthma at home. Methods: The telemedical system was used for remote / home diagnostics in 37 children with asthma and 39 healthy aged from 5 to 14 years. Remote diagnostics was performed using the developed technology of computer analysis of respiratory sounds recorded by an electronic stethoscope on the front surface of the neck over the trachea for 25 seconds. The telemedicine system worked via the patient’s smartphone (Fig.1). For a point over the trachea, the telemedicine system selectes a frequency range for analyzing and calculating the wheezing index (Kw) based on the patient’s age. When the value of the wheezing index is over 46%, the presence of wheezing in asthma was diagnosed. For children under 10 years old, the frequency interval was from 1400 to 1800 Hz, for children from 10 to 16 years, the frequency interval was from 1200 to 1600 Hz. Results: This method was convenient for home use. The operational indicators of the method were Se = 70%, Sp = 90%, the accuracy of the method = 79%, the cut point for Kw was 46% (Fig. 2). Conclusion: Thus, this telemedicine system can be used at home for the remote diagnosis of asthma in children. The computerized respiratory sound analysis method turned out to be quite effective with high sensitivity and specificity, which automatically took the child’s age into account when analyzing respiratory sounds.