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Childhood respiratory disorders may be diagnosable with a smartphone

Automated cough analysis technology in a smartphone app could help diagnose childhood respiratory disorders, according to an Australian study published in Respiratory Research. Researchers at Curtin University and the University of Queensland found that their smartphone app had high accuracy (81–97%) for diagnosing asthma, croup, pneumonia, lower respiratory tract disease, and bronchiolitis. The authors used similar technology to that used for speech recognition software, which they trained by a machine learning approach to recognise features of coughs characteristic for five different respiratory diseases. The researchers then used the app to categorise the coughs of 585 children aged between 29 days and 12 years at two hospitals in Western Australia. The accuracy of the automated cough analyser was determined by comparing its diagnosis with that of a panel of paediatricians after they had reviewed the results of imaging, laboratory findings, and hospital charts, and undertaken all appropriate clinical investigations. Both positive agreement (both the app and the panel diagnosed the disorder) and the negative agreement values (neither the app nor the panel diagnosed the disorder) exceeded 80% for all orders, and were particularly good for asthma (97% positive agreement, 91% negative agreement). The authors noted that the technology can provide a diagnosis without the need for clinical examination by a doctor, addressing a major limiting feature of existing telehealth consultations for providing clinical services remotely. Removing the need for a clinical examination may allow targeted treatments to begin sooner. Dr Porter said: “As the tool does not rely on clinical investigations, it can be used by health care providers of all levels of training and expertise. However, we would advise that where possible the tool should be used in conjunction with a clinician to maximise the clinical accuracy.”

https://respiratory-research.biomedcentral.com/articles/10.1186/s12931-019-1046-6

Pill testing could save the lives of first‐time ecstasy users

Pill‐testing services at music festivals may be most effective in reducing harm for people who are taking ecstasy for the first time, but is less effective for those who have used it previously, according to research from Edith Cowan University published in Drug and Alcohol Review. The study assessed ecstasy‐using intentions after different pill testing scenarios in order to determine the factors that predict subsequent risky behaviour. More than 250 music festival attenders were presented with three hypothetical pill test scenarios and reported their risk intentions, ecstasy use history, and sensation‐seeking. The findings suggested that festival attenders who might be looking to try ecstasy for the first time are most cautious after a pill test, regardless of its outcome. People who had used ecstasy previously (60% of the study participants) were more likely to reduce their harm intentions if the ecstasy was found to contain a toxic contaminant, but not if the test indicated a high dose or produced an inconclusive result. Participants who had previously taken ecstasy and were also high in sensation‐seeking were at the greatest risk of harm, even after a pill test. Experienced ecstasy users were no more knowledgeable than novices with regard to safe doses and harmful ingredients. Festival attenders would be willing to pay an average $12 subsidy to fund pill testing services, the researchers found. Dr Ross Hollett, study author, said that introducing counselling and drug education services alongside formal pill testing could further reduce the risk of harm.

https://doi.org/10.1111/dar.12936