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: 10261583
• 负责人: Farrokh Ayazi
• 金额: $ 7.55万
• 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 2023-06-30
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10261583
• 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; 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; Testing; Time; Veins; Visit; Walking; Wheezing; Work; asthma exacerbation; asthmatic patient; base; body position; cardiopulmonary system; clinical Diagnosis; cost; design; detection method; 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.

综述：呼吸系统疾病(RDS)是美国第五大死亡原因，造成超过1500亿美元的损失 医疗保健成本。像哮喘一样，RDS是无法治愈的，如果不及时治疗可能会危及生命。就像大多数 危险的RDS是渐进的，通过预防性治疗是可控的，及早发现是预防的关键 病情恶化。目前的诊断依赖于昂贵且耗时的临床就诊，这阻碍了预防性的 没有严重症状的筛查，特别是对于中低收入人群，由于 接触烟草和与工作有关的颗粒物。RDS样哮喘的诊断也依赖于对 间歇性异常呼吸音，可从临床以外的长时间录音中受益。 在本项目中，将开发一种低成本、低调、易用、有效的外膜检测设备 哮喘呼吸音，便于对RD患者进行筛查和持续治疗监测。 听诊是一种强大的、非侵入性的、成熟的心肺健康评估方法。 系统通过肺音和心音。听诊器已经被医生们使用了两个多世纪。 诊所，但由于外形因素较大，不适合持续监测心肺活动 依赖于倾听技能和经验，禁止动态监控和 早期发现儿童RDS。存在对低调、小型化、高精度诊断的需求 更易接近的设备，可在长时间内准确检测和量化呼吸异常 测量时不需要依靠医生的技能和经验来解释声音。为此， 基于MEMS的加速度计接触式麦克风(ACM)的电子接口和声耦合 皮肤将经过优化，以高保真的方式记录呼吸声音，并与临床诊断进行比较。 将使用突破性的、密封的、具有单向振动灵敏度的高精度ACM 要克服标准听诊器的限制，这些听诊器体积大，容易受到空气和摩擦噪声的影响，而且很硬 来使用。除了肺音和心音外，ACM还可以同时获得呼吸频率、心率和体力 用户的活动。数据将使用时频分析和连续分析等简单算法进行分析 小波变换通过检测特征声音为哮喘诊断提供可靠的信息 在100赫兹-5千赫兹的宽频率范围内喘息。要求诊断的准确性和全面性 要通过启用ACM的延长录音来改进，将呼吸声音与心脏关联的能力 声音和身体运动，以及检测更高频率的信号。ACM和皮肤之间的接口将是 经过优化，可在较宽的频率范围内增加宽带外来声音的声学耦合。低- Profile可穿戴ACM将在临床环境中用于检测外膜呼吸声音 并与医用级数字听诊器和临床医生的判断进行比较。ACM的潜力 检测其他RDS的信息，如慢性阻塞性肺病和肺炎，也将为未来的发展进行评估。