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Luac Richeldi

The Italian physician has been diagnosing rare pulmonary diseases for decades. He is an expert in his field. With the help of new digital tools he wants to be still faster and better.

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For more than 200 years, the stethoscope has been one of the most important devices for physicians. However, when it comes to diagnosing rare pulmonary diseases, it is only of limited suitability. An algorithm should provide urgent assistance.

Luca Richeldi is an unassuming man. He speaks in a quiet and considered way and tends to be reserved – both in his tone and in what he says. He would never claim to be an expert in his field: the diagnosis and treatment of rare pulmonary diseases. Yet, that is exactly what he is. Hailing from Italy, he originally established the chair for rare pulmonary diseases at the University of Modena. Today, he practises at the Gemelli University Hospital in Rome as a professor and director for pulmonary and respiratory diseases – and counts no less a person than the Pope as one of his patients.

His standard diagnostic tool is the stethoscope. Richeldi uses it to listen to his patients’ lungs and airways in order to determine the cause of their complaints. However, even the most experienced specialists quickly come up against their limits. “ Diagnosing rare pulmonary diseases, such as idiopathic pulmonary fibrosis (IPF), is extremely complicated,” he explains. “With the stethoscope, you can hear that something isn’t right with the lungs,” says Richeldi. “However, inexperienced doctors – in particular – do not necessarily go on to identify IPF, but rather assume that cardiac problems, asthma or other pulmonary diseases are the cause of the very specific sound pattern.” It takes an average of 17 months to confirm a diagnosis of IPF after the onset of the initial symptoms. An eternity for patients – and lost time, since the serious disease can often be terminal. The earlier it is identified, the better the treatment outcomes are.

“We firmly believe that this auscultation aid will reduce misdiagnoses and identify rare diseases like IPF much faster.”

Allan Hillgrove,
Member of the Board of Managing Directors with responsibility for Human Pharma

This is how the Auscultation Aid works

A digital stethoscope or a standard stethoscope with an easy-to-attach high-quality digital microphone transmits the patient’s lung sounds to the application on a mobile phone through Bluetooth.

The app analyses the auscultation sounds and compares them to references, enabling the detection of abnormal sound patterns.

In order to support the identification of IPF at an earlier stage, Boehringer Ingelheim is developing an artificial intelligence-based “Auscultation Aid” which works as follows: a stethoscope with a digital interface is linked via a mobile phone to a cloud-based large sound database. Using artificial intelligence, a patient’s lung sound recordings are then compared with reference data from the sound database. This database was created from recorded and confirmed diagnoses of lung diseases, collected in large clinical studies. The auscultation aid immediately sends the physician a result in the form of a “probability score” for a certain lung disease. If this score is higher than a pre-specified treshold value, the tool will provide suggestions to the examining physician for additional diagnostic steps, examinations and procedures.

“We firmly believe that this auscultation aid will enable a reduction in misdiagnoses and identify rare diseases like IPF much faster,” says Allan Hillgrove, Member of the Board of Managing Directors with responsibility for the Human Pharma Business Unit at Boehringer Ingelheim. He adds that the device covers a previously unresearched area and will therefore create genuine added value for patients.