{"version":"6.9","hitCount":1,"request":{"queryString":"ext_id:41619752 AND src:med","internalQuery":"ext_id:41619752 AND src:med","resultType":"CORE","cursorMark":"*","pageSize":25,"sort":"","synonym":false},"resultList":{"result":[{"id":"41619752","source":"MED","pmid":"41619752","doi":"10.1016/s0140-6736(25)02156-7","title":"Triple cardiovascular disease detection with an artificial intelligence-enabled stethoscope (TRICORDER) in the UK: a cluster-randomised controlled implementation trial.","authorString":"Kelshiker MA, Bächtiger P, Petri CF, Nakhare S, Mansell J, Chhatwal K, Alrumayh A, Zaman J, Shah M, Young H, Roy H, Almonte MT, Costelloe C, Razak Y, Majeed A, Howard JP, Barton C, Kramer DB, Plymen CM, Peters NS.","authorList":{"author":[{"fullName":"Kelshiker MA","lastName":"Kelshiker","firstName":"Mihir A","initials":"MA","authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"National Heart and Lung Institute, Imperial College London, London, UK; Imperial College Healthcare NHS Trust, London, UK."}]}},{"fullName":"Bächtiger P","lastName":"Bächtiger","firstName":"Patrik","initials":"P","authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"National Heart and Lung Institute, Imperial College London, London, UK; Imperial College Healthcare NHS Trust, London, UK."}]}},{"fullName":"Petri CF","lastName":"Petri","firstName":"Camille F","initials":"CF","authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"National Heart and Lung Institute, Imperial College London, London, UK."}]}},{"fullName":"Nakhare S","lastName":"Nakhare","firstName":"Saloni","initials":"S","authorId":{"type":"ORCID","value":"0000-0001-5879-5780"},"authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"National Heart and Lung Institute, Imperial College London, London, UK."}]}},{"fullName":"Mansell J","lastName":"Mansell","firstName":"Josephine","initials":"J","authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"National Heart and Lung Institute, Imperial College London, London, UK."}]}},{"fullName":"Chhatwal K","lastName":"Chhatwal","firstName":"Karanjot","initials":"K","authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"National Heart and Lung Institute, Imperial College London, London, UK."}]}},{"fullName":"Alrumayh A","lastName":"Alrumayh","firstName":"Abdullah","initials":"A","authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"National Heart and Lung Institute, Imperial College London, London, UK."}]}},{"fullName":"Zaman J","lastName":"Zaman","firstName":"Jahed","initials":"J","authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"National Heart and Lung Institute, Imperial College London, London, UK."}]}},{"fullName":"Shah M","lastName":"Shah","firstName":"Moulesh","initials":"M","authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"National Heart and Lung Institute, Imperial College London, London, UK."}]}},{"fullName":"Young H","lastName":"Young","firstName":"Holly","initials":"H","authorId":{"type":"ORCID","value":"0000-0002-4631-6700"},"authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"School of Public Health, Imperial College London, London, UK."}]}},{"fullName":"Roy H","lastName":"Roy","firstName":"Helena","initials":"H","authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"Hasso Plattner Institute, University of Potsdam, Potsdam, Germany."}]}},{"fullName":"Almonte MT","lastName":"Almonte","firstName":"Melanie T","initials":"MT","authorId":{"type":"ORCID","value":"0000-0003-2448-4866"},"authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"National Heart and Lung Institute, Imperial College London, London, UK."}]}},{"fullName":"Costelloe C","lastName":"Costelloe","firstName":"Céire","initials":"C","authorId":{"type":"ORCID","value":"0000-0002-3475-7525"},"authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"School of Public Health, Imperial College London, London, UK."}]}},{"fullName":"Razak Y","lastName":"Razak","firstName":"Yasmin","initials":"Y","authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"NHS North West London Integrated Care System, London, UK."}]}},{"fullName":"Majeed A","lastName":"Majeed","firstName":"Azeem","initials":"A","authorId":{"type":"ORCID","value":"0000-0002-2357-9858"},"authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"School of Public Health, Imperial College London, London, UK."}]}},{"fullName":"Howard JP","lastName":"Howard","firstName":"James P","initials":"JP","authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"National Heart and Lung Institute, Imperial College London, London, UK."}]}},{"fullName":"Barton C","lastName":"Barton","firstName":"Carys","initials":"C","authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"Imperial College Healthcare NHS Trust, London, UK."}]}},{"fullName":"Kramer DB","lastName":"Kramer","firstName":"Daniel B","initials":"DB","authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"National Heart and Lung Institute, Imperial College London, London, UK; Harvard Medical School, Cambridge, MA, USA."}]}},{"fullName":"Plymen CM","lastName":"Plymen","firstName":"Carla M","initials":"CM","authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"National Heart and Lung Institute, Imperial College London, London, UK; Imperial College Healthcare NHS Trust, London, UK."}]}},{"fullName":"Peters NS","lastName":"Peters","firstName":"Nicholas S","initials":"NS","authorAffiliationDetailsList":{"authorAffiliation":[{"affiliation":"National Heart and Lung Institute, Imperial College London, London, UK; Imperial College Healthcare NHS Trust, London, UK. Electronic address: n.peters@imperial.ac.uk."}]}}]},"authorIdList":{"authorId":[{"type":"ORCID","value":"0000-0001-5879-5780"},{"type":"ORCID","value":"0000-0002-2357-9858"},{"type":"ORCID","value":"0000-0002-3475-7525"},{"type":"ORCID","value":"0000-0002-4631-6700"},{"type":"ORCID","value":"0000-0003-2448-4866"}]},"dataLinksTagsList":{"dataLinkstag":["altmetrics"]},"journalInfo":{"issue":"10529","volume":"407","journalIssueId":4122904,"dateOfPublication":"2026 Feb","monthOfPublication":2,"yearOfPublication":2026,"journal":{"medlineAbbreviation":"Lancet","title":"Lancet (London, England)","essn":"1474-547X","issn":"0140-6736","nlmid":"2985213R","isoabbreviation":"Lancet"},"printPublicationDate":"2026-02-01"},"pubYear":"2026","pageInfo":"704-715","abstractText":"<h4>Background</h4>Early detection of cardiovascular disease is a global public health priority. Artificial intelligence (AI)-enabled stethoscopes offer robust performance characteristics in point-of-care detection of heart failure, atrial fibrillation, and valvular heart disease (VHD). We conducted a pragmatic, cluster-randomised controlled implementation trial to determine the real-world effect and implementation challenges of AI-stethoscopes.<h4>Methods</h4>UK primary care practices were cluster randomised 1:1 to intervention (training and implementation in use of AI-stethoscopes in routine care) or control (routine care). Given the nature of the intervention, masking of participants (practices, clinicians, and patients) was not feasible. During cardiac examinations, the AI stethoscope recorded 15 s of single-lead electrocardiogram and phonocardiogram signals for input to three AI algorithms that returned binary predictions for the presence or absence of reduced left ventricular ejection fraction (≤40%), atrial fibrillation, and VHD (all with regulatory approval). The primary endpoint was incidence of any newly coded diagnosis of heart failure (all subtypes), expressed per 1000 patient-years (incidence rate ratio [IRR]), derived from a UK National Health Service Secure Data Environment. A coprimary endpoint stratified detection of heart failure by place of diagnosis (community-based vs via hospital admission). Secondary endpoints included atrial fibrillation and VHD detection rates, performance characteristics of the AI-stethoscope, use rates, and clinician-reported implementation barriers and enablers.<h4>Findings</h4>Between Oct 30, 2023, and May 22, 2024, 205 practices were randomly assigned (96 to the intervention arm [701 933 registered patients] and 109 to the control arm [851 242 registered patients]). Intervention practices recorded 12 725 patient examinations with the AI-stethoscope, across 972 clinical users. Intention-to-treat analysis found heart failure detection did not differ between groups (IRR 0·94 [95% CI 0·86-1·02]); with no difference in community-based or hospital-based diagnoses (p>0·05).<h4>Interpretation</h4>Implementation of an AI stethoscope in routine primary care did not significantly increase detection of heart failure or increase community-based diagnosis after 12 months of implementation. AI stethoscope use was independently associated with significantly higher detection rates of heart failure, as well as atrial fibrillation and VHD. This randomised controlled implementation trial establishes a pragmatic design with randomisation that generates real-world data essential for understanding and overcoming the barriers to implementation of innovation in health care.<h4>Funding</h4>National Institute for Health and Care Research, British Heart Foundation, and Imperial Health Charity.","affiliation":"National Heart and Lung Institute, Imperial College London, London, UK; Imperial College Healthcare NHS Trust, London, UK.","publicationStatus":"ppublish","language":"eng","pubModel":"Print-Electronic","pubTypeList":{"pubType":["Randomized Controlled Trial","Pragmatic Clinical Trial","Journal Article"]},"grantsList":{"grant":[{"agency":"National Institute for Health Research Applied Research Collaboration South London","orderIn":0},{"agency":"British Heart Foundation","acronym":"BHF_","grantId":"RE/24/130023","orderIn":0},{"agency":"Imperial College London","orderIn":0},{"agency":"Imperial Health Charity","orderIn":0},{"agency":"National Institute for Health Research Imperial Biomedical Research Centre","orderIn":0},{"agency":"Invention for Innovation","orderIn":0},{"agency":"Imperial College Healthcare NHS Trust","orderIn":0},{"agency":"National Institute for Health Research (NIHR)","orderIn":0}]},"meshHeadingList":{"meshHeading":[{"majorTopic_YN":"N","descriptorName":"Humans"},{"majorTopic_YN":"Y","descriptorName":"Cardiovascular Diseases","meshQualifierList":{"meshQualifier":[{"majorTopic_YN":"N","abbreviation":"DI","qualifierName":"diagnosis"}]}},{"majorTopic_YN":"Y","descriptorName":"Atrial Fibrillation","meshQualifierList":{"meshQualifier":[{"majorTopic_YN":"N","abbreviation":"DI","qualifierName":"diagnosis"}]}},{"majorTopic_YN":"N","descriptorName":"Electrocardiography"},{"majorTopic_YN":"N","descriptorName":"Early Diagnosis"},{"majorTopic_YN":"Y","descriptorName":"Stethoscopes"},{"majorTopic_YN":"N","descriptorName":"Algorithms"},{"majorTopic_YN":"Y","descriptorName":"Artificial Intelligence"},{"majorTopic_YN":"N","descriptorName":"Adult"},{"majorTopic_YN":"N","descriptorName":"Middle Aged"},{"majorTopic_YN":"N","descriptorName":"Primary Health Care"},{"majorTopic_YN":"N","descriptorName":"Female"},{"majorTopic_YN":"N","descriptorName":"Male"},{"majorTopic_YN":"Y","descriptorName":"Heart Failure","meshQualifierList":{"meshQualifier":[{"majorTopic_YN":"N","abbreviation":"DI","qualifierName":"diagnosis"},{"majorTopic_YN":"N","abbreviation":"EP","qualifierName":"epidemiology"}]}},{"majorTopic_YN":"N","descriptorName":"United Kingdom","meshQualifierList":{"meshQualifier":[{"majorTopic_YN":"N","abbreviation":"EP","qualifierName":"epidemiology"}]}}]},"subsetList":{"subset":[{"code":"IM","name":"Index Medicus"}]},"fullTextUrlList":{"fullTextUrl":[{"availability":"Subscription required","availabilityCode":"S","documentStyle":"doi","site":"DOI","url":"https://doi.org/10.1016/S0140-6736(25)02156-7"}]},"isOpenAccess":"N","inEPMC":"N","inPMC":"N","citedByCount":15,"hasReferences":"Y","hasTextMinedTerms":"Y","hasDbCrossReferences":"N","hasPDF":"N","hasBook":"N","hasSuppl":"N","hasLabsLinks":"Y","hasData":"N","license":"cc by","authMan":"N","epmcAuthMan":"N","nihAuthMan":"N","hasTMAccessionNumbers":"N","dateOfCompletion":"2026-02-14","dateOfCreation":"2026-01-31","dateOfRevision":"2026-03-09","electronicPublicationDate":"2026-01-28","firstPublicationDate":"2026-01-28","firstIndexDate":"2026-02-06","hasEvaluations":"N"}]}}