A Non-invasive, Wearable, Miniaturized Auscultation Device for Diagnosis of Pulmonary Diseases

用于诊断肺部疾病的无创、可穿戴、小型听诊装置

• 批准号: 10058025
• 负责人: Farrokh Ayazi
• 金额: $ 8.71万
• 依托单位: GEORGIA INSTITUTE OF TECHNOLOGY
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-09-15 至 2022-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10058025
• 关键词: Accelerometer; Acoustics; Age; Air Sacs; Algorithmic Analysis; Algorithms; Ambulatory Monitoring; Asthma; Auscultation; Blood flow; Body mass index; Cardiac; Cardiopulmonary; Cardiovascular system; Cause of Death; Cessation of life; Chest wall structure; Child; Chronic Obstructive Airway Disease; Clinic; Clinical; Cone; Consumption; Coupling; Crackles; Dangerousness; Data; Dependence; Detection; Development; Devices; Diagnosis; Diagnostic; Diagnostic Procedure; Disease; Disease Progression; Early Diagnosis; Entropy; Erythema Infectiosum; Evaluation; Frequencies; Future; Goals; Health; Health Care Costs; Health Status; Healthcare Systems; Heart; Heart Rate; Heart Sounds; Home environment; Immune; Income; Individual; Judgment; Life; Liquid substance; Lung; Lung diseases; Maps; Measurement; Medical; Methods; Microgravity; Monitor; Motion; Noise; Organ; Outpatients; Output; Particulate; Patients; Physical activity; Physicians; Pneumonia; Population; Positioning Attribute; Preventive care; Preventive screening; Preventive treatment; Progressive Disease; Pulmonary Fibrosis; Pus; Quantitative Evaluations; Reading; Respiratory Sounds; Respiratory System; Running; Sampling; Schools; Signal Transduction; Skin; Stethoscopes; Structure; Surface; Symptoms; Techniques; Testing; Time; Veins; Visit; Walking; Wheezing; Work; asthma exacerbation; asthmatic patient; base; body position; cardiopulmonary system; clinical Diagnosis; cost; design; diagnostic accuracy; digital; disability; disorder risk; effective therapy; electric impedance; experience; health care settings; heart rate monitor; improved; interstitial; lung injury; microdevice; microphone; miniaturize; nanofabrication; noninvasive diagnosis; personalized diagnostics; portability; prevent; prototype; reduce symptoms; respiratory; screening; seal; sensor; skills; sound; tobacco exposure; tool; vibration

Summary: Respiratory diseases (RDs) are the fifth cause of death in the US and impose over $150B on healthcare cost. RDs like asthma are incurable and can be life-threatening if not treated promptly. As most dangerous RDs are progressive and manageable with preventive treatment, early detection is crucial to prevent exacerbation. Current diagnosis relies on costly and time-consuming clinical visits, discouraging preventative screening without severe symptoms especially for low/middle-income population at higher RD risks due to more exposure to tobacco and work-related particulates. Diagnosis of RDs like asthma also relies on detection of intermittent abnormal respiratory sounds, which can benefit from prolonged recordings outside the clinic setting. In this project, a low-cost, low-profile, easy-to-use and effective device will be developed to detect adventitial asthma respiratory sounds, facilitating access to screening and continuous treatment monitoring in RD patients. Auscultation is a powerful, non-invasive and well-established method to evaluate health of cardiopulmonary system through sounds of lung and heart. Stethoscopes have been used by physicians for over two centuries in clinics, but they are unsuitable for continuous cardiopulmonary activities monitoring due to large form-factor and dependence on listening skills and experience, prohibiting critical applications like ambulatory monitoring and early detection of RDs in small children. A need exists for a low-profile, miniaturized, high-precision diagnostic device that is more accessible and can accurately detect and quantify respiratory abnormalities over prolonged measurements without relying on the skills and experience of a physician to interpret the sounds. To that end, the electronic interface and acoustic coupling of a MEMS-based accelerometer contact microphone (ACM) onto skin will be optimized to record respiratory sounds with high fidelity, and compared against clinical diagnosis. Breakthrough, hermetically-sealed, high-precision ACMs with unidirectional vibration sensitivity will be used to overcome limits of standard stethoscopes that are bulky, susceptible to airborne and rubbing noise, and hard to use. Besides lung and heart sounds, the ACM simultaneously acquires respiratory rate, heart rate and physical activities of the users. Data will be analyzed using simple algorithms like time-frequency analysis and continuous wavelet transformation to provide reliable information for diagnosis of asthma by detecting signature sounds like wheezing in a wide frequency range of 100Hz-5kHz. Diagnosis accuracy and comprehensiveness are expected to be improved by the ACM-enabled prolonged recording, capability of correlating respiratory sounds with heart sounds and body motions, and detection of higher frequency signals. Interface between ACM and skin will be optimized to increase acoustic coupling over a wide frequency range for wideband adventitious sounds. Low- profile wearable ACMs will be used in a clinical setting to detect adventitial respiratory sounds indicative of asthma and compared with medical-grade digital stethoscopes and clinician judgment. Potentials of the ACM for detecting information for other RDs like COPD and pneumonia will also be assessed for future developments.

摘要：呼吸道疾病（RDS）是美国第五个死亡原因，在150B 医疗保健费用。像哮喘一样的RD是无法治愈的，如果不及时治疗，可能会威胁生命。大多数 危险的RD是渐进的，可以通过预防治疗来管理，早期发现对于防止 恶化。当前的诊断依赖于昂贵且耗时的临床访问，阻碍了预防性 筛查没有严重症状的筛查，尤其是对于较高的RD风险的低/中等收入人群，由于更多 暴露于烟草和与工作有关的颗粒。哮喘等RDS的诊断也依赖于检测 间歇性异常呼吸道声音可以受益于诊所环境外的长时间记录。 在这个项目中，将开发低成本，低调，易于使用和有效的设备来检测外来 哮喘呼吸道声音，促进RD患者的筛查和连续治疗监测的访问。 听诊是一种评估心肺健康状况的强大，无创和公认的方法 通过肺和心脏的声音进行系统。医生已经使用了两个多世纪的医生 诊所，但由于大型因子和 依赖听力技能和经验，禁止务必进行的关键应用，例如卧床监测和 早期发现RD的小孩。存在低调，微型，高精度诊断的需求 更容易访问且可以准确检测和量化呼吸异常的设备。 测量不依赖医生的技能和经验来解释声音。为此， 基于MEMS的加速度计麦克风（ACM）的电子界面和声耦合到 皮肤将被优化以记录具有高富度性的呼吸道声音，并与临床诊断进行比较。 突破性，密封密封的高精度ACM将使用单向振动敏感性 要克服笨重，容易受到空气和摩擦噪声的标准听诊器的限制， 使用。除了肺和心脏声音，ACM还获得呼吸率，心率和身体 用户的活动。将使用简单算法（例如时频分析和连续）分析数据 小波转换以提供可靠的信息来诊断哮喘，通过检测签名听起来像 在100Hz-5kHz的频率范围内喘息。诊断准确性和全面性 要通过启用ACM的长时间记录来改善，将呼吸声与心脏相关的能力 声音和身体运动，以及更高频率信号的检测。 ACM和皮肤之间的接口将是 优化以增加宽带范围内宽带不定声音的声音耦合。低的- 配置可穿戴ACM将在临床环境中使用，以检测出现的呼吸道声音指示 哮喘，并与医学级的数字听诊器和临床医生的判断进行比较。 ACM的电势 还将评估其他RDS（例如COPD和肺炎）的信息，以进行未来的发展。