Every ten seconds, someone in the UK has a potentially life-threatening asthma attack, according to Asthma UK. Research suggests that globally children under the age of five with asthma are more likely to require urgent healthcare than at any other age.
Wheeze is the most common symptom in under-fives, and therefore a wheezy asthmatic child is a good indicator of the onset of an asthma attack. However, accurately detecting wheeze is very difficult without clinical training and the use of a stethoscope, which means that parents can struggle to manage their child’s condition from home, particularly as these young children are unable to properly express how they are feeling and what their symptoms are.
As a result, parents often struggle to know when to ramp up treatment to avoid exacerbation of symptoms and a trip to A&E.
On learning about these challenges, medical device company OMRON decided to dig a little deeper into why parents struggle with detecting wheeze in their young children. This move is very much in line with OMRON’s ambitious strategy of eradicating asthma attacks through its respiratory devices, explains the company’s product group manager Jean Paul Eekhout.
The result of OMRON’s research is a product called WheezeScan – a clinically validated wheeze detection device for home-use in children aged between four months and seven years. It is CE marked and available in the UK, Germany and six other European countries.
The challenge of detecting wheeze in young children
Although some parents are very confident about their ability to detect wheeze in their child, a study found that 60% of parents failed to identify a wheeze correctly on video. Other studies found that between 13% and 39% of parents struggled to identify wheeze in their young children.
This issue is acknowledged by clinicians; 80% who responded to an OMRON survey said parents are unable to identify wheezing correctly in asthmatic children.
Although wheeze is defined as “a whistling sound” when a child breathes by Asthma UK, a major issue is that this sound can be easily confused with other heavy breathing sounds, noted OMRON director of connected service and solutions Paul Stevens at a launch event for WheezeScan.
This detection challenge is an issue as wheeze is one asthma symptom where doctors advise the quick use of a reliever inhaler to prevent the onset or worsening of an asthma attack, noted Stevens. Therefore, failure to detect wheeze early can affect parent’s ability to know when to medicate.
This is also linked with a tendency of parents to avoid over-medicating unnecessarily since asthma medication is associated with many unpleasant symptoms, leading to a situation where parents often under-medicate, increasing the risks of further exacerbation of symptoms and admission to hospital.
These issues with wheeze detection are even more acute for parents with young children. Older children can vocalise their need for an inhaler because they are feeling wheezy, but this is not the case for the under-fives. They may express discomfort and seem unwell but pinpointing the cause of that is a serious challenge.
Building confidence with WheezeScan
Identifying wheeze and preventing asthma attacks is something parents have to do alone. It is not feasible for them to take their child to the GP or hospital every time they are concerned about a wheeze. Instead, caregivers need to feel confident that they can identify the wheeze and intervene appropriately with medication to stop an asthma attack in its tracks.
To provide a second opinion and confidence to parents, OMRON decided to develop WheezeScan for children aged between four months and seven years. As Eekhout noted at the launch, WheezeScan takes the guesswork out of wheeze detection. The device can tell parents what their very young children cannot.
Eekhout explains this fully portable device is essentially a “very sensitive microphone, which is supported by noise-cancelling circuity to really allow the device to home in on the sound”. It is specifically designed to be placed on the right-hand side of the child’s chest, so the device does not misinterpret sounds from the heart. It also can detect low-volume sounds that parents may struggle to hear otherwise.
Within 30 seconds, the device displays a clear reading of either ‘wheeze’ or ‘no wheeze’ to remove any confusion for parents. This determination is based on OMRON’s clinically validated algorithms.
“We have studied thousands of these sounds [from children with wheeze] and built an algorithm that allows the device to do pattern recognition and check against a database,” explains Eekhout. “The device is able to distinguish the different sounds associated with wheezing, but also exclude the types of sounds not considered to be part of the wheeze”.
A clinical study published in October 2020 by OMRON and Japanese academics found that WheezeScan’s algorithms had 100% sensitivity and almost 96% specificity at detecting wheeze.
In addition, Eekhout notes WheezeScan is incredibly good at picking up the wheeze earlier than the untrained ear. This is crucial as timely detection of wheeze is crucial to preventing an exacerbation of symptoms and an asthma attack.
Although the WheezeScan device itself tells parents if their child is wheezing or not, OMRON also decided to develop a paired companion app. The AsthmaDiary app was created because parents expressed interest in being able to keep track of wheezing episodes alongside their child’s asthma management and treatment plan. Therefore, enabling patients to “build up a complete profile” of their child’s condition and help identify trends and trigger factors surrounding their wheezing, explains Eekhout.
Not replacing clinicians or parents
Eekhout is very clear that the aim of WheezeScan is not to replace the parent in the detection of wheeze. It is about empowering parents to better manage their young child’s asthma, particularly around timely administration of medicine and minimising the risks of an exacerbation. Ultimately it is the parent that has to make the decision about administering medication to avoid an asthma attack, and WheezeScan aims to give them more confidence to do so.
He also notes that it is important that WheezeScan is not used as a diagnostics tool for asthma. “The sole responsibility [for diagnosis] lies with the healthcare professional. Parents should not consider WheezeScan as a replacement for a healthcare professional”. Instead, the device supports parents in looking after their young child and following a treatment plan set out by their doctor.
However, Eekhout notes that now WheezeScan is available across Europe, OMRON is looking to launch the device in other markets. Since in the developing world, often healthcare professionals are not trained to the same standard as in Europe, OMRON is exploring the possibility of providing WheezeScan to healthcare professionals to reassure them about their diagnosis of wheezing children.
OMRON has the aim of launching WheezeScan worldwide and is working with regulatory bodies globally to make that happen, concludes Eekhout.