Automated Interpretation of Lung Sounds by Deep Learning in Children With Asthma: Scoping Review and Strengths, Weaknesses, Opportunities, and Threats Analysis

Background: The interpretation of lung sounds plays a crucial role in the appropriate diagnosis and management of pediatric asthma. Applying artificial intelligence (AI) to this task has the potential to better standardize assessment and may even improve its predictive potential.

Objective: This study aims to objectively review the literature on AI-assisted lung auscultation for pediatric asthma and provide a balanced assessment of its strengths, weaknesses, opportunities, and threats.

Methods: A scoping review on AI-assisted lung sound analysis in children with asthma was conducted across 4 major scientific databases (PubMed, MEDLINE Ovid, Embase, and Web of Science), supplemented by a gray literature search on Google Scholar, to identify relevant studies published from January 1, 2000, until May 23, 2023. The search strategy incorporated a combination of keywords related to AI, pulmonary auscultation, children, and asthma. The quality of eligible studies was assessed using the ChAMAI (Checklist for the Assessment of Medical Artificial Intelligence).

Results: The search identified 7 relevant studies out of 82 (9%) to be included through an academic literature search, while 11 of 250 (4.4%) studies from the gray literature search were considered but not included in the subsequent review and quality assessment. All had poor to medium ChAMAI scores, mostly due to the absence of external validation. Identified strengths were improved predictive accuracy of AI to allow for prompt and early diagnosis, personalized management strategies, and remote monitoring capabilities. Weaknesses were the heterogeneity between studies and the lack of standardization in data collection and interpretation. Opportunities were the potential of coordinated surveillance, growing data sets, and new ways of collaboratively learning from distributed data. Threats were both generic for the field of medical AI (loss of interpretability) but also specific to the use case, as clinicians might lose the skill of auscultation.

Conclusions: To achieve the opportunities of automated lung auscultation, there is a need to address weaknesses and threats with large-scale coordinated data collection in globally representative populations and leveraging new approaches to collaborative learning.