FDA clears way for an AI stethoscope to detect heart disease The US Food and Drug Administration has approved the first artificial intelligence algorithm powering a digital stethoscope for doctors to detect valvular heart disease more accurately. Valvular heart disease arises when the heart's valves don't function correctly, impacting the pumping of blood to the body and the intake …
The Withings smartwatch takes an ECG and can detect atrial fibrillation, as can the alternatives from Samsung, Apple etc.
For valvular heart disease detection and blood pressure, they do have a separate arm-mounted cuff, so those may be more difficult to measure from just the wrist.
To be honest , detecting AF is not exactly rocket science
Doctor: does it feel like your heart goes racing while your pulse stays about normal?
Patient: Yes
Doctor: heres a heart moniter, wear it for 24 hrs, then give it back at the desk and I'll call if it shows anything
VF ... now thats a trickier thing to diagnose...
If a doctor asked me: does it feel like your heart goes racing while your pulse stays about normal?, I'd answer: No
I have AF - my heart rate will zoom up easily to 160/180, possibly higher. But I literally never feel it at all. Never any feeling of racing. Even when watching a screen showing my ECG traces meaning I am prompted by seeing the rate go up, I still don't notice it.
(Found simply by a GP doing a BP test and noticing heart rate. BP was OK.)
And wearing a proper monitor showed nothing. It simply didn't happen during the time I wore one.
But a very cheap wrist band did show pretty much exactly what the ECG had shown.
Therefore, detecting AF might not be rocket science, but asking the patient alone, and even in conjunction with a Holter, is inadequate for some of us.
My GP, in the arse end of nowhere, works 3 days a week, earns the best part of £100k and doesn't even treat patients face to face. I long for the day when these grifters are put out to pasture through superior AI diagnosis technologies. Actually I would really like the NHS to be dismantled to the point where it's emergencies only and my taxes are liberated in the process, but that's a topic for another day.
Things have certainly changed.
Until he retired in 1980, my GP worked 5.5 days a week, with two surgeries per day (no appointments needed) Monday to Friday and one on Saturdays, did all his own home visits between surgeries and any after hours call outs, and earned a flat fee from HMG per patient on his list, out of which he had to maintain his surgery premises and cover his expenses. He not only cured his patients' ailments - he made them feel better while they were recovering and alleviated their worries about it. When he retired he was widely missed.
What we have now I refer to as "Quickfit Euro medicine" - drop off your ailment and come back in half an hour when some technician has fixed it.
With the current trend in goverments you'll be in luck for the NHS being dismantled. But I'd assume the only liberating of your taxes you'll see will be into the pockets of the owners of "heathcare providers" (that have suspiciously close ties to the ministers in charge of commisioning the services)
Ausculation has been on the way out for quite a long time: many doctors aren't properly trained in it nowadays, making some of the measurements a tad difficult to assess without a more in-depth read (which I haven't done obvs.)
I wonder if doctors will keep the stethoscope as a "symbol of medicine" once none of them know how to use it?
I visited my GP surgery a couple of days ago.
Was seen by an associate, who probably qualified somewhere else, so no full registration here, and gets paid less. Still, a living, breathing medic than the lesser spotted full-fat GP variety.
With regards to my dicky ticker, she did take the blood pressure, but did not listen to the heart.
At least she's going to refer me up to the specialist, and booking me in for an EEG (EKG)
Only nurses wear stethoscopes now. And fewer and fewer of them: it was used by nurses to take blood pressure on nursing rounds, (you use it to detect when the pressure cuff has released enough to allow peripheral pulse) but that is being replaced by automatic detection.
Now that doctors don't wear white coats, and nurses don't wear uniforms, you can identify Doctors by the 'smart casual' clothing, and Nurses by the stethoscope.
Funny, I visited my doctor a couple months ago, because my heart would occasionally race. She just hooked me up to an EEG, got a heartbeat readout for a minute, looked at the readout print, noted a couple irregularities, and referred me to a cardiologist for further testing. I currently have a little device pasted on my chest, recording everything for analysis.
So how is this supposed to improve on this? The GP visit took 15 minutes. The cardiologist visit to get outfitted with the recorder took less than that, and it's tracking me for two weeks.
As a recently retired doc I can comment on the AI tool with some confidence. No doc (and that includes Cardiologists) nowadays would dream of relying on auscultation for much information about heart valves! We listen to hearts sometimes but that is a tiny part of any serious assessment.
If there is any doubt about the heart valves then some combination of echocardiogram, ECG and blood tests would be a minimum.
The reason for doing those tests is seldom that a murmur has been heard. You can of course have severe heart and valve problems without abnormal heart sounds.
In the pre-antibiotic era gross valvular heart disease causing murmurs was common. Now it is pretty uncommon if not rare in developed societies.
The tool may well be better than most docs at finding abnormalities. Most modern ECG machines produce a printout showing abnormalities too. Nearly all these can be ignored on sight as they are of “no clinical importance” - in other words they don’t matter at all. They just worry patients and sometimes cause unnecessary further investigations.
The question is does the tool produce clinically useful results - does it improve patient care?
I just finished my latest cardiologist test. It involved 8 or 10 sensors (I lost track) glued to my chest and plugged into an ECG machine. Then a dye was injected along with a chemical to induce stress. I was then wheeled into (literally) a CT-Scan machine. I never saw the cardiologist. He analyzed the results and sent them to my GP who will review them with me next week.
People who think that a smartwatch or a fancy stethoscope can figure out what's going on are deluded.
A general check-up used to involve listening to the heart. If you know what to listen for, that still detects unexpected conditions -- unless you are planning to just send all of your patients to a cardiologists all the time at every presentation for cold or flu or pregnancy or broken arm.
The problem is that you have to listen to every patient every time to get a clear idea of normal and abnormal heart sounds. Very few doctors do that now.
They are reporting that around 1% of COVID cases result in heart conditions, most of which are easily detectable, few of which are easily fixed. Exactly the kind of thing primary care physicians use to do:
"To Cure Sometimes, to Relieve Often, to Comfort Always"
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