Scientific article
Open access

Deep learning diagnostic and risk-stratification pattern detection for COVID-19 in digital lung auscultations: clinical protocol for a case-control and prospective cohort study

Published inBMC pulmonary medicine, vol. 21, no. 1, 103
Publication date2021-03-24
First online date2021-03-24

Background: Lung auscultation is fundamental to the clinical diagnosis of respiratory disease. However, auscultation is a subjective practice and interpretations vary widely between users. The digitization of auscultation acquisition and interpretation is a particularly promising strategy for diagnosing and monitoring infectious diseases such as Coronavirus-19 disease (COVID-19) where automated analyses could help decentralise care and better inform decision-making in telemedicine. This protocol describes the standardised collection of lung auscultations in COVID-19 triage sites and a deep learning approach to diagnostic and prognostic modelling for future incorporation into an intelligent autonomous stethoscope benchmarked against human expert interpretation.

Methods: A total of 1000 consecutive, patients aged ≥ 16 years and meeting COVID-19 testing criteria will be recruited at screening sites and amongst inpatients of the internal medicine department at the Geneva University Hospitals, starting from October 2020. COVID-19 is diagnosed by RT-PCR on a nasopharyngeal swab and COVID-positive patients are followed up until outcome (i.e., discharge, hospitalisation, intubation and/or death). At inclusion, demographic and clinical data are collected, such as age, sex, medical history, and signs and symptoms of the current episode. Additionally, lung auscultation will be recorded with a digital stethoscope at 6 thoracic sites in each patient. A deep learning algorithm (DeepBreath) using a Convolutional Neural Network (CNN) and Support Vector Machine classifier will be trained on these audio recordings to derive an automated prediction of diagnostic (COVID positive vs negative) and risk stratification categories (mild to severe). The performance of this model will be compared to a human prediction baseline on a random subset of lung sounds, where blinded physicians are asked to classify the audios into the same categories.

Discussion: This approach has broad potential to standardise the evaluation of lung auscultation in COVID-19 at various levels of healthcare, especially in the context of decentralised triage and monitoring.

Trial registration: PB_2016-00500, SwissEthics. Registered on 6 April 2020.

  • Artificial intelligence
  • Auscultation
  • COVID-19
  • Deep learning
  • Pneumonia
  • Respiratory sounds
  • Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Algorithms
  • Auscultation / methods
  • COVID-19 / diagnosis
  • COVID-19 Testing / methods
  • Case-Control Studies
  • Clinical Decision Rules
  • Clinical Protocols
  • Deep Learning
  • Female
  • Humans
  • Male
  • Middle Aged
  • Prognosis
  • Prospective Studies
  • Risk Assessment
  • Triage
  • Young Adult
  • Hôpitaux Universitaires de Genève - [135-SIA-SARS-CoV-2 COVID]
  • Square Point Capital -
  • Georg Waechter Memorial Foundation -
Citation (ISO format)
GLANGETAS, Alban et al. Deep learning diagnostic and risk-stratification pattern detection for COVID-19 in digital lung auscultations: clinical protocol for a case-control and prospective cohort study. In: BMC pulmonary medicine, 2021, vol. 21, n° 1, p. 103. doi: 10.1186/s12890-021-01467-w
Main files (1)
Article (Published version)
Secondary files (1)
ISSN of the journal1471-2466

Technical informations

Creation09/01/2022 9:57:46 AM
First validation05/02/2023 3:15:43 PM
Update time05/02/2023 3:15:43 PM
Status update05/02/2023 3:15:43 PM
Last indexation05/06/2024 3:47:43 PM
All rights reserved by Archive ouverte UNIGE and the University of GenevaunigeBlack