Mobile Screening

Summary:

One Heart Mobile Health Application (“App”) is a telemedicine system to support local health providers to identify signs of congenital heart diseases (CHD) and reduce its late diagnosis in low resource settings. The One Heart App enables local health workers to inexpensively record and transmit heart sounds from children with signs of CHD to obtain consultation from specialists through mobile networks. The One Heart App aims to reduce morbidity and mortality associated with CHD by providing early screening that does not require a specialist.

Funding Objective:

The One Heart App (pre-alpha version) has been tested in in rural China during several pilot screening programs. Our funding objective is to further develop the software (Alpha version) for targeted users and research their practical use at partner hospitals in West Virginia, USA; Gansu and Yunnan Provinces, China; and India. The experience from these pilot programs will lead to the next version (Beta version) with usability testing and final release of the One Heart App for real-world clinical use.

Completed Work:

We developed early versions of One Heart App based on the first-hand observation of the late diagnosis of CHD and challenges associated early CHD screening in collaboration with Children’s HeartLink, a non-government organization based in Minnesota with the mission of improving access to high-quality heart care in underserved areas. The first version of the One Heart App system consisted an iOS-based mobile software application and a custom made digital stethoscope for recording of heart sounds. During outreach programs in county hospitals in Linxia and Huining, Gansu Province of China, we successfully collected digital heart sounds using the One Heart system. A trained cardiologist (Dr. Pyles) could differentiate 18 pathologic murmurs from one innocent murmur using signals collected by the One Heart system in comparison with standard auscultation and echocardiography. The results were presented at the American Heart Association Scientific Session in 2012 at Los Angeles, US.

After the pilot study in Gansu, China, we developed a second software application on an Android system (pre-alpha version) with additional telemedicine functions of communication via mobile network for remote consultation. In collaboration with Children’s HeartLink partner site in Kunming Medical University and First Affiliated Hospital (KMU), we participated in a screening program in Menghai County, Yunnan Province of China in December 2014. The KMU team screened 7,993 children for signs of CHD using standard auscultation.

We collected digital heart sounds from 149 children with suspected murmurs using the One Heart App.  Using echocardiography as the reference method, a trained cardiologist (Dr. Pyles) using the One Heart App found pathologic murmurs in 11 of 14 subjects with true CHD. Three missed were atrial septal defect called venous hum in two of three patients; likely related to respiratory artifact. Accuracy was 136/149 or 91% with 10 false positives. Positive predictive value was 52% and negative predictive value 98%. The results of this study have been published in Pediatric Cardiology.¹One Heart Telemedicine System:

The One Heart Telemedicine System enables communication of CHD screening information between remote clinic or referral sites with pediatric heart centers at regional hospitals.

About One Heart Health

Established in 2017, the mission of One Heart Health is to improve health outcomes through early diagnosis of heart disease in children who live in low resourced areas of the world using cost-effective medical technologies. One Heart Health is a 501(c)(3) tax-exempt nonprofit organization.

Reference:

1. Initial Field Test of a Cloud-Based Cardiac Auscultation System to Determine Murmur Etiology in Rural China. Pyles L, Hemmati P, Pan J, Yu X, Liu K, Wang J, Tsakistos A, Zheleva B, Shao W, Ni Q. Pediatr Cardiol. 2017 Feb 2 online.