NORMAL LUNG SOUNDS REGISTRATION

Despite research and advances in therapy, ILDs remain a worldwide health challenge affecting millions of people each year, emphasizing the need to make progress in diagnosis and prevention.ĭifferent measures have been proposed to improve the early diagnosis of ILDs. Until now, with limited treatment options benefiting mostly patients in the early stages of the disease, many patients will progress towards disability or death. However, the distinction is useful as their response to treatment differs markedly. Distinguishing between IPF and NSIP raises considerable diagnostic challenges as their clinical presentations share many overlapping features. However, given the initial non-specific symptomatic presentation, the need for advanced diagnostic tools, such as high-resolution chest CT (HRCT), and an expertise in the early-stage diagnosis of IPF and NSIP remain desirable and achievable objectives. With a mean delay of 2.2 years between the onset of symptoms and specialist referral, the investigation of competing diagnoses by non-specialist providers can be costly for both patients and healthcare providers. Delay in specialist referral is associated with a higher mortality, irrespective of disease severity. Identifying patients with IIP at the earliest possible stage is essential for care management as treatment is aimed at slowing the irreversibly debilitating and ultimately fatal progression. In turn, IIP comprises a range of sub-pathologies, such as idiopathic pulmonary fibrosis (IPF) and non-specific interstitial pneumonia (NSIP).

Two-thirds are of idiopathic aetiology and comprise a range of subcategories, the most common of which is idiopathic interstitial pneumonia (IIP). Approximately one-third of these disorders have known endogenous or exogenous causes, including environmental or occupational factors, infections, drugs and radiation. Interstitial lung disease (ILD) encompasses several pulmonary conditions defined by an alteration of the pulmonary interstitium, a restrictive pattern of lung function, and fibrotic scarring on chest computed tomography (CT).

NORMAL LUNG SOUNDS REGISTRATION

Trial registration Registration: August 8, 2022. This approach has a broad potential to better guide care management by exploring the synergistic value of several point-of-care-tests for the automated detection and differential diagnosis of ILD and COPD and to estimate severity. Based on previous work to distinguish normal and pathological lung sounds, we estimate to achieve convergence with an area under the receiver operating characteristic curve of > 80% using 40 patients in each category, yielding a sample size calculation of 80 ILD (40 IPF, 40 NSIP), 40 COPD, and 40 controls. Quality of life will be measured with dedicated questionnaires. Secondary outcomes are the clinical, functional and radiological characteristics of IPF, NSIP and COPD diagnosis. The primary outcome is the diagnosis of ILD versus control subjects or COPD. A deep learning algorithm ( DeepBreath) using convolutional neural networks, long short-term memory models, and transformer architectures will be trained on these audio recordings and LUS images to derive an automated diagnostic tool. Lung auscultation will be recorded with a digital stethoscope at 10 thoracic sites in each patient and LUS images using a standard point-of-care device will be acquired at the same sites. At inclusion, demographic and clinical data will be collected. This protocol describes the standardised collection of digitally-acquired lung sounds and LUS images of adult outpatients with IPF, NSIP or COPD and a deep learning diagnostic and severity-stratification approach.Ī total of 120 consecutive patients (≥ 18 years) meeting international criteria for IPF, NSIP or COPD and 40 age-matched controls will be recruited in a Swiss pulmonology outpatient clinic, starting from August 2022. Artificial intelligence-assisted lung auscultation and ultrasound (LUS) could constitute an alternative to conventional, subjective, operator-related methods for the accurate and earlier diagnosis of these diseases. Prompt and accurate diagnosis is important to enable patients to receive appropriate care at the earliest possible stage to delay disease progression and prolong survival. Interstitial lung diseases (ILD), such as idiopathic pulmonary fibrosis (IPF) and non-specific interstitial pneumonia (NSIP), and chronic obstructive pulmonary disease (COPD) are severe, progressive pulmonary disorders with a poor prognosis.

Normal lung sounds