May 23, 2022

The stethoscope has come a long way since its humble beginnings in the 1800s. The regular acoustic type is still used every day, but an arsenal of digital options have been added that can amplify or convert heart sounds into electrical signals. Echo, a company founded in 2013, has focused on bringing applied AI to the stethoscope space. Now there is real data that suggests that the company has made progress, receiving a $30 million expansion in the previous Round C to continue its work.

The Echo hardware consists of a digital stethoscope with some basic features such as noise reduction technology or the ability to record and visualize heartbeats. But the company has also changed some FDA-approved clinical support algorithms.

In 2020, the FDA approved the 510(k) set of Eko algorithms that help detect heart murmurs and atrial fibrillation, or AFib. (A company earns this when it demonstrates that its technology is comparable to what is already available.) This approval was supported by additional clinical results. published IN Journal of the American Heart Association in 2021. On Tuesday, Eco announced that this algorithm will be the basis of a new software called the Echo App. According to Conor Landgraf, CEO and co-founder of Eeco, this integration will strengthen Eeco’s position in the field of applied AI.

Eko’s has been working on the development of analytical capabilities based on machine learning. But for now, the company has focused on devices and clinical instruments. This software launch will be the company’s first real foray into more sophisticated AI applications.

What does the new software mean for doctors? This is not “machine learning of the brain” yet. Essentially, the doctor can listen to heart sounds and take ECGs just like before, while the new software records this data in the background. It then provides an analysis or interpretation of this ECG rhythm, which can help alert the physician to the presence of atrial fibrillation or heart murmurs.

“The doctor basically gets the analysis report or summary of the patient’s heart sounds, lung sounds and ECG data right in the examination room with the patient,” he said.

Echo stethoscope. image credit: environment

At first glance, this may remind you of something like the Apple Watch, another device with FDA-approved software for detecting atrial fibrillation. The Echo is heavily oriented towards the practical side rather than the consumer side. Instead, think of this new software as a Clinical Decision Support System (CDS). These systems, which appear everywhere from radiology to hematology, do not actually make a diagnosis, but are designed to help doctors interpret medical data.

Such systems are not new, but they are becoming more common and many US hospitals use them regularly. However, there are indications that the CDS system is slowly being introduced into outpatient clinics or smaller non-hospital healthcare systems. According to Landgraf, Acko is trying to reach out to these smaller clinics with its own tools and algorithms.

“The goal is to be able to empower the specialist. to say it [cardiology expertise] In the hands of a rural therapist or an emergency doctor or a specialist nurse in a polyclinic,” he said.

However, detection of atrial fibrillation and heart murmurs is not the company’s ultimate goal. As COO Jason Bellett told gaming-updates after the close of the 2019 Acko Series A round, the company is indeed ready to “detect structural heart disease and heart failure.”

Heart failure affects approximately 7 million people in the US and is expected to reach 8 million by 2030. According to an estimate published in BMC Medicine, it accounts for 1 to 2% of US health care spending.

EKO collaboration with 3M Littmann: digital and acoustic stethoscope. image credit: environment

The company has made progress in this area, but has not yet received FDA approval for the algorithm’s clinical use. In January, an independent study by the UK’s National Health System found that a different algorithm, developed in conjunction with the Mayo Clinic, could signal signs of a weak heart. In a study of 1,050 patients, the Echo device was able to detect, after 15 seconds of listening, when the left ventricular ejection fraction (LVEF) was 40%, the limit at which heart failure could occur.

Currently, about 80% of cases of heart failure in the UK are diagnosed in hospitals, but 40% of these patients show symptoms of the disease: required Could be upgraded sooner, NHS study notes. In addition, it is not always easy to confirm the diagnosis of heart failure. This usually includes several blood tests, exercise tests, a biopsy, an ECG, an echocardiogram, or a chest scan. There is no single gold standard for a non-invasive diagnostic test for heart failure.

Landgraf said the goal of the program is to replace routine screening as a way to check for heart failure. He envisions something like a mammogram or colonoscopy for heart failure using non-invasive technology in a primary care office.

I[Heart failure] These are huge costs, and yet we are not well versed in the early detection of this disease, ”he said. “We figure it out, you know, years later, it’s up to that patient. We are missing the opportunity to cure this patient at an early stage. And that’s what we really want to change with this technology.”

Acko also closed a $30 million expansion for its previous Series C round, bringing the company’s total funding to $125 million. Landgraf said this expansion will allow the company to support further efforts to commercialize and develop new products.

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