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AI phone app detects worsening heart failure based on changes in patients' voices

A smartphone app using artificial intelligence technology to detect changes in the voice of a person with heart failure predicted more than 75% of hospitalizations about three weeks before they happened, according to late-breaking science presented Nov. 13 at the American Heart Association's Scientific Sessions 2023. The meeting, held Nov. 11–13, in Philadelphia, is a premier global exchange of the latest scientific advancements, research and evidence-based clinical practice updates in cardiovascular science. "Speech analysis is novel technology that may be a useful tool in remote monitoring of heart failure patients, providing early warning of worsening heart failure that frequently results in hospitalization," said lead study author William T. Abraham, M.D., FAHA, a professor of medicine, physiology and cell biology; and a College of Medicine Distinguished Professor in the division of cardiovascular medicine at The Ohio State University Wexner Medical Center in Columbus. "This technology has the potential to improve patient outcomes, keeping patients well and out of the hospital, through the implementation of proactive, outpatient care in response to voice changes." Heart failure occurs when the heart muscle can't pump enough blood to meet the body's needs for blood and oxygen. This can result in fatigue, fluid retention, shortness of breath and sometimes excessive coughing. This study evaluated the effectiveness of the artificial intelligence-driven mobile app to predict worsening heart failure in advance of any need for hospitalization and /or intravenous treatment among people diagnosed with heart failure. The mobile phone app was designed to detect changes in speech measures in patients over time. The voice changes could indicate early increases of lung fluid, which is a sign of progressing heart failure. The study was conducted from March 2018 through April 2023 and enrolled 416 adults living in Israel diagnosed with heart failure. Study participants recorded five sentences in their native language—Hebrew, Russian, Arabic or English—into the phone app daily. In a training phase of the study, distinct speech measures from 263 participants were used to develop the AI algorithm. Then, the algorithm was used in the remaining 153 participants to validate the tool's effectiveness. The analysis found: In the training phase of the study, the app accurately predicted 76% of worsening heart failure (44 of the 58 heart failure events) on average 24 days before hospitalization or the need for IV fluids occurred. The app generated an average of three unnecessary alerts per patient, per year. In the validation phase, the app was 71% accurate in detecting heart failure events about 3 weeks in advance (detecting 10 of 14 events). There were about three unexplained alerts per patient per year in this group as well. Researchers conclude that the technology detects future worsening heart failure episodes accurately, with a low unnecessary notification rate. This high rate of accuracy and early notification of worsening heart failure validate the AI tool as a potentially effective way to reduce hospitalization and improve patient outcomes. Study background: The technology used in this study was the Cordio HearO system, a remote monitoring system comprised of a smartphone-based mobile speech application. About 75% of the participants were men, and their average age was 68 years. The 263 patients in the training phase, made recordings on 83% of days between March 27, 2018—November 30, 2021 and were followed for up to 44 months. The test group of 153 patients made recordings on 81% of days between February 1,2020—April 30, 2023 and followed for up to 31 months. The distinct speech measures included pitch, volume, dynamics, and other characteristics. While statistically valid, the number of participants in the study was small, which is a limitation of the study. An ongoing U.S.-based study will add to the experience in further training and validating the technology, Abraham said.

  • 23 November, 11:51
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Boss of Indonesia cough syrup maker jailed after child deaths

The boss and three other officials of an Indonesian firm whose cough syrup was linked to the deaths of over 200 children have been sentenced to jail. They were handed two-year prison sentences and fined 1bn Indonesian rupiah ($63,056; £51,786). The firm, Afi Farma, was accused of producing cough syrups containing excess amounts of toxic substances. The company's lawyer said they denied negligence and the firm was considering whether to appeal. Prosecutors had been seeking a prison sentence of up to nine years for Afi Farma's chief executive, Arief Prasetya Harahap, and seven years each for the other defendants. The Public Prosecutor said that between October 2021 and February 2022 the company received two batches of propylene glycol, which is used for making cough syrup. These batches contained 96% to 99% ethylene glycol, the prosecutor said. Both substances can be used as additives to solvents. While, propylene glycol is non-toxic and widely used in medicines, cosmetics and food, ethylene glycol is toxic and used in paint, pens and brake fluid. The company did not test the ingredients used in the cough syrup and instead relied on quality and safety certificates from its supplier, prosecutors said. Afi Farma's lawyer, Samsul Hidayat, told the BBC that Indonesia's drug regulator did not require drug makers to carry out rigorous testing of ingredients. The judge in the Kediri District Court, East Java, found the four defendants guilty of intentionally producing pharmaceutical goods that did not meet safety standards. The case comes as efforts grow worldwide to tighten the oversight of drug supply chains after the poisonings. Since 2022, more than 200 Indonesian children, most of whom were under the age of five, have died of acute kidney injury linked to contaminated cough syrup. About 100 deaths have been reported in The Gambia and Uzbekistan. The World Health Organization (WHO) has issued warnings about six cough syrups made in India and Indonesia.

  • 7 November, 12:07
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