• Andrzej Emeryk, Eric Derom, Kamil Janeczek, Barbara Kuźnar-Kamińska, Anna Zelent, Mateusz Łukaszyk, Tomasz Grzywalski, Anna Pastusiak, Adam Biniakowski, Krzysztof Szarzyński, Dick Botteldooren, Jędrzej Kociński, and Honorata Hafke-Dys.
• Department of Paediatric Pulmonology and Rheumatology, Faculty of Medicine, Medical University of Lublin, Lublin, Poland (A.E., K.J.).
• Ann Fam Med. 2023 Nov 1; 21 (6): 517525517-525.

PurposeThe advent of new medical devices allows patients with asthma to self-monitor at home, providing a more complete picture of their disease than occasional in-person clinic visits. This raises a pertinent question: which devices and parameters perform best in exacerbation detection?MethodsA total of 149 patients with asthma (90 children, 59 adults) participated in a 6-month observational study. Participants (or parents) regularly (daily for the first 2 weeks and weekly for the next 5.5 months, with increased frequency during exacerbations) performed self-examinations using 3 devices: an artificial intelligence (AI)-aided home stethoscope (providing wheezes, rhonchi, and coarse and fine crackles intensity; respiratory and heart rate; and inspiration-to-expiration ratio), a peripheral capillary oxygen saturation (SpO2) meter, and a peak expiratory flow (PEF) meter and filled out a health state survey. The resulting 6,029 examinations were evaluated by physicians for the presence of exacerbations. For each registered parameter, a machine learning model was trained, and the area under the receiver operating characteristic curve (AUC) was calculated to assess its utility in exacerbation detection.ResultsThe best single-parameter discriminators of exacerbations were wheezes intensity for young children (AUC 84% [95% CI, 82%-85%]), rhonchi intensity for older children (AUC 81% [95% CI, 79%-84%]), and survey answers for adults (AUC 92% [95% CI, 89%-95%]). The greatest efficacy (in terms of AUC) was observed for a combination of several parameters.ConclusionsThe AI-aided home stethoscope provides reliable information on asthma exacerbations. The parameters provided are effective for children, especially those younger than 5 years of age. The introduction of this tool to the health care system might enhance asthma exacerbation detection substantially and make remote monitoring of patients easier.© 2023 Annals of Family Medicine, Inc.

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