Wednesday, 11 November 2020

Covid-19: researchers at work to speed up the diagnostic process

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Physicians can quickly access to a lot of detailed information from a portable device, at the bedside, in a hospital, at home or in residential homes, with no need to move the patients. The prognostic value of the protocol devised by the Department of Information Engineering and Computer Science of the University of Trento was validated today for the first time in “The Journal of Ultrasound in Medicine”. The protocol will now be tested on a larger scale. Part of the testing is taking place in Rovereto.

In research settings and clinical practice, many scientists are working to help diagnose Covid-19 as fast as possible, at the patient's bed, with no need to visit other hospital wards, reducing the risk of infection. A first important step towards a portable device that can support the diagnostic process comes from the project developed at the Department of Information Engineering and Information Science of the University of Trento, in collaboration with various national hospitals. Introduced last spring, the protocol is based on ultrasound examination of the lungs, carried out through a wireless device connected to a tablet or similar portable device.

It is like having a lung expert by your side: the system provides real time information to doctors to monitor the health conditions of patients with Covid-19 pneumonia. Doctors can decide in a matter of minutes if a patient must be admitted to the hospital or if home care is more appropriate. 

The new step forward lies in having demonstrated, for the first time, the clinical value of the analysis carried out through ultrasound data. The study, which appeared today in the “Journal of Ultrasound in Medicine”, involved 52 patients with Covid-19 from Policlinico San Matteo in Pavia. Their health status was assessed and monitored over a period of time using the new protocol. 

Another study is already underway now with a larger patient cohort, to further validate the positive results achieved. This study will be carried out in collaboration with some important hospitals, including Ospedale Gemelli in Roma, Policlinico San Matteo in Pavia, the hospitals of Brescia and Lodi and Ospedale di S. Maria del Carmine in Rovereto, thanks to a partnership with the Provincial Health Care Service.

Moreover, the results of the study reached “The Journal of the Acoustical Society of America”, which invited Libertario Demi to report on progress made.

A better diagnostic process can lead to a more efficient triage: "The software update gives a response in a matter of seconds – explained Libertario Demi. With just one piece of equipment we can examine more than 6 patients per hour. If you multiply this number for all available devices, the testing and monitoring capacity is significantly increased".

About the new protocol
Information and knowledge from the world's top experts in lung ultrasound were collected and organized in the software application. Their expertise is now quickly available to the medical community, in a functional way, free of charge, just a few clicks away. You just have to load the patient's scans and the software automatically compares them with data available, providing an accurate analysis based on which doctors can make a diagnosis. 

Artificial intelligence provides speed and accuracy, it really makes a difference: it collects and analyses data, showing any abnormalities in changes in the structure of the network of pulmonary alveoli and interstitial tissue in real time. This will enable doctors to make a quick and accurate diagnosis. Ultrasound imaging (ultrasonography) reveal specific patterns that enable doctors to understand patients’ conditions and choose the best possible treatment. Ultrasound waves, in other words, are used to 'take a picture' of the lungs and reveal any alterations.

"It is up to doctors to make a diagnosis. But the software update can be of great help. It keeps on learning and improving as it acquires more data" commented Libertario Demi, coordinator of the ICLUS project of the University of Trento. This solution is easily implemented: it is already available through a web application thanks to which doctors from all over the world can have algorithms examined in real time. Besides, patients in care can be monitored from remote places, and doctors can monitor the evolution of lung disease in patients who have been diagnosed with Covid-19.
This solution also offers various advantages over alternative imaging technologies such as computed tomography, CT. It does not use ionising radiation, can be installed on portable and easy to use devices, including in developing countries and rural areas, and have a minimal risk of contamination because patients don't have to be transferred".