Smartphone App Developed to Help People Recognize If They’re Having a Heart Attack or Stroke

• Mass General Brigham researchers found app was highly sensitive at detecting patients requiring emergency evaluation
• More work is needed before the app can be approved for use

Investigators from Mass General Brigham have developed and validated a smartphone app that helps patients decide at home if they need to seek emergency care for a heart attack or stroke. The work is described in a study published in JMIR Formative Research.

“Most individuals with symptoms have called a medical line and heard the unsatisfactory statement, ‘If this is an emergency please hang up and call 911.’  This warning places the burden back on the patient, who in many cases does not know if it is an emergency,” said lead author Amar Dhand, MD, DPhil, an attending physician in the Department of Neurology at Brigham and Women’s Hospital (BWH), a founding member of the Mass General Brigham healthcare system. “We have developed an app that can indicate if it is likely an emergency situation.”

Dhand and his colleagues tested their app, called ECHAS (Emergency Call for Heart Attack and Stroke) in 202 patients who visited an emergency department with symptoms of possible stroke or heart attack. The app assessed patients through a series of questions regarding symptoms and a phone-based finger-tapping test to detect one-sided muscle weakness (a hallmark of stroke).

The team found that the ECHAS app was highly sensitive at detecting the need for evaluation in an emergency department and at detecting the need for hospital admission. It had a sensitivity of 0.98 for identifying patients in whom emergency department evaluation was appropriate, and correctly identified every person who required hospital admission, without missing any patients.

Patients completed the evaluation on the app in an average of 111 seconds for the stroke pathway and 60 seconds for the heart attack pathway. When surveyed, patients reported that the app was easy to use and valuable for personal emergency situations at home.

“We plan to conduct a prospective clinical trial to confirm the app’s accuracy, and test its ability to detect situations in which emergency evaluation is, and is not, needed,” said co-author Jim Muller, MD, a cardiologist at BWH and a Nobel Laureate. “The app will be most useful for patients and families when symptoms are mild or ambiguous; these are instances when an expert opinion is helpful to reduce delay.”

Dhand and Muller, who are co-founders of ECHAS, have also released a product that people can download to learn about the symptoms of heart attack and stroke through an illustrated and narrated experience. The app, ECHAS Lifeline, is for informational purposes only and should not be considered professional medical advice.

Authorship: Additional authors include Rama Mangipudi, Anubodh S Varshney, Jonathan Crowe, Andria L Ford, Nancy K Sweitzer, Min Shin, Samuel Tate, Haissam Haddad, Michael E Kelly, and Jay S Shavadia.

Disclosures: Jim Muller and Amar Dhand are co-founders of ECHAS, LLC.

Funding: This work was funded by ECHAS, LLC.

Paper cited: Dhand A et al. “Assessment of the Sensitivity of a Smartphone App to Assist Patients in Identification of Stroke and Myocardial Infarction: Cross-Sectional Study ” JMIR Form Res DOI: 10.2196/60465