Heart failure patients make up about a quarter of all re-hospitalizations in Israel and around the world. A new development, based on a sample of the patient’s voice, manages to detect such a deterioration long before it occurs and may save many billions in unnecessary hospitalization expenses. At the beginning of December, it will be presented by its Israeli developers at the annual ICI Conference on Innovation in Invasive Cardiology, which will be held in Tel Aviv for the 27th year.
The field of cardiology is full of groundbreaking technologies: from tiny stents that are inserted into the body and change their shape according to the surgeon’s direction, to the use of a three-dimensional model of the heart itself that the surgeon can “hold” in his hand during surgery. But one of the recent developments, which promises to detect in advance a deterioration in the condition of heart failure patients, is based on none other than the cell phone that each of us has in our pocket.
This development, like many others in the field, comes from Israel. The “Cordio” company from Or Yehuda, founded by Prof. Haim Lotan, a senior cardiologist who previously served as the director of the cardiac system at Hadassah Ein Kerem Hospital. Lotan, in collaboration with a group of local doctors and scientists, was able to produce software that analyzes the patient’s voice in heart failure and can predict a deterioration in his condition about a week before the patient reaches a state where he needs to be re-hospitalized. All this with the help of an app on the patient’s phone, with the help of which he records himself saying regular sentences every day. The artificial intelligence that analyzes the patient’s voice manages to detect changes in the patient’s condition, and can actually prevent the patient from being hospitalized due to his deteriorating condition.
Heart failure patients are responsible for about 25% of all re-hospitalizations, so if the development of Cordio is put into use by the HMOs, the state could save many billions on hospitalizations that will be saved.
Heart failure is the most common chronic disease in the world. More than 20 million people worldwide suffer from heart failure. In Western countries – including Israel – the rate of people suffering from this syndrome is about 2%. The significance of this figure: about 180,000 Israelis suffer from heart failure. Every year, about 12,000 new diagnoses join them. About 2,500 Israelis suffer from advanced heart failure, and their condition is defined as “difficult.”
“It is a disease that is usually common in older people, and it is on the rise both because of the increased life expectancy and because of the large increase in diabetes, which is one of the causes of heart failure,” explains Prof. Haim Lotan. “The patients are heart failure patients, this is a crazy cost to the state. Therefore, there was a great need to identify those patients whose condition is deteriorating, long before it reaches a state where re-hospitalization is required.”
Have there been attempts by other companies in the field?
“Certainly, many companies are trying their luck in this area with a variety of technological solutions, including devices that are implanted in the heart and are supposed to detect such deterioration, or patches and other wearable products. These experiments seemed successful, but patients’ response to these measures was very small. It is clear to us that the problem needs to be attacked from a completely different direction.”
How does your method actually work in recognizing the patient’s voice?
“A patient with deteriorating heart failure increases the amount of fluid in the lungs. Now that your lungs are full of fluids, your voice changes. Not to the level that a normal ear can hear, but changes can certainly be seen if the patient’s voice is analyzed using artificial intelligence. , I could often notice that the voice of the difficult patients changed due to the accumulation of fluids in their lungs as their condition deteriorated, but when I noticed it, it was already in the 90th minute, when the patient’s condition was already deteriorating. “Before we see the patient in the emergency room.”
The experiment that began on dialysis patients
The first experiment was conducted by the people of Cordio on dialysis patients at Hadassah, whose bodies accumulate fluids in large quantities, and after the dialysis treatment, these fluids are replaced by the body. “We modeled the voices of these patients at all stages – before the fluid accumulated and at each stage along the way as their bodies accumulated fluids. After a computerized mathematical analysis we could actually see the differences in their voices at each stage using graphs that went up, Lotan adds.
At the next stage, the development on heart failure patients at the Rambam Hospital in Haifa has already been tried. “We took patients who came to the hospital with heart failure,” Lotan explains, “we modeled their voice every day until they improved. This way we could also reach their basic voice, when they do not suffer from deterioration in the situation and hence we could compare their voice at any time and detect deterioration, when it appears. Every day they said one or two sentences to the app, and that’s it. “In this experiment, we were able to reach an accuracy level of 80-90% and we actually identified many patients who were in the direction of deteriorating their condition, long before it happened.”
What is the benefit of detecting such a deterioration before it occurs?
“Through the app we developed, the attending physician receives the information about his patient on a daily basis, straight to the phone or computer and he can immediately change the patient’s treatment, help him with rehabilitative devices and in a big way – stabilize his condition and not cause him to be hospitalized. “Outpatient centers for cardiac rehabilitation, which are just waiting for patients to arrive. The funds are of course happy because it saves them the hospitalization money.”
When will the development go into use by the HMOs?
“I hope so soon. We have already received the European and Israeli approval, and the FDA has put us on a fast track as a breakthrough technology. We are now raising funds for research to be conducted at various medical centers in the United States for approval there. I estimate that within a year and a half to two years “.
Do you see future voice surgery for other diseases?
“Certainly, in the future we will be able to expand the use of technology for use among patients with other lung diseases like asthma or COPD. This development will not only detect deterioration in the condition and immediate treatment before the patient needs hospitalization, it will also save billions on all hospitalizations saved.”
The development of “Cordio”, along with dozens of new developments in the field of heart will be presented at ICI, the annual conference for innovation in invasive cardiology to be held between 5-7 December 2021 in Tel Aviv with the participation of over 1,500 doctors, entrepreneurs, researchers, representatives of giant companies, funding bodies and funds Venture capital from around the world. This is the 27th year that this conference has been held in Israel and through it, hundreds of developments in the field of the heart have been unveiled, which have received great funding and success around the world. This year, the $ 200,000 De Haan Prize will be awarded to the leading innovation company.