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Semmad A, Bahoura M. Comparative study of respiratory sounds classification methods based on cepstral analysis and artificial neural networks. Comput Biol Med 2024; 171:108190. [PMID: 38387384 DOI: 10.1016/j.compbiomed.2024.108190] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/08/2023] [Revised: 01/30/2024] [Accepted: 02/18/2024] [Indexed: 02/24/2024]
Abstract
In this paper, we investigated and evaluated various machine learning-based approaches for automatically detecting wheezing sounds. We conducted a comprehensive comparison of these proposed systems, assessing their classification performance through metrics such as Sensitivity, Specificity, and Accuracy. The main approach to developing a machine learning-based system for classifying respiratory sounds involved the combination of a technique for extracting features from an unknown input sound with a classification method to determine its belonging class. The characterization techniques used in this study are based on the cepstral analysis, which was extensively employed in the automatic speech recognition field. While MFCC (Mel-Frequency Cepstral Coefficients) feature extraction methods are commonly used in respiratory sounds classification, our study introduces a novelty by employing GFCC (Gammatone-Frequency Cepstral Coefficients) and BFCC (Bark-Frequency Cepstral Coefficients) for this purpose. For the classification task, we employed two types of neural networks: the MLP (Multilayer Perceptron), a feedforward neural network, and a variant of the LSTM (Long Short-Term Memory) recurrent neural network called BiLSTM (Bidirectional LSTM). The proposed classification systems are evaluated using a database consisting of 497 wheezing segments and 915 normal respiratory segments, which are recorded from individuals diagnosticated with asthma and individuals without any respiratory issues, respectively. The highest classification performance was achieved by the BFCC-BiLSTM model, which demonstrated an exceptional accuracy rate of 99.8%.
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Affiliation(s)
- Abdelkrim Semmad
- Department of Engineering, Université du Québec à Rimouski, 300, allée des Ursulines, Rimouski, Qc, Canada, G5L 3A1.
| | - Mohammed Bahoura
- Department of Engineering, Université du Québec à Rimouski, 300, allée des Ursulines, Rimouski, Qc, Canada, G5L 3A1.
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Sethi AK, Muddaloor P, Anvekar P, Agarwal J, Mohan A, Singh M, Gopalakrishnan K, Yadav A, Adhikari A, Damani D, Kulkarni K, Aakre CA, Ryu AJ, Iyer VN, Arunachalam SP. Digital Pulmonology Practice with Phonopulmography Leveraging Artificial Intelligence: Future Perspectives Using Dual Microwave Acoustic Sensing and Imaging. SENSORS (BASEL, SWITZERLAND) 2023; 23:5514. [PMID: 37420680 DOI: 10.3390/s23125514] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/31/2023] [Revised: 06/01/2023] [Accepted: 06/05/2023] [Indexed: 07/09/2023]
Abstract
Respiratory disorders, being one of the leading causes of disability worldwide, account for constant evolution in management technologies, resulting in the incorporation of artificial intelligence (AI) in the recording and analysis of lung sounds to aid diagnosis in clinical pulmonology practice. Although lung sound auscultation is a common clinical practice, its use in diagnosis is limited due to its high variability and subjectivity. We review the origin of lung sounds, various auscultation and processing methods over the years and their clinical applications to understand the potential for a lung sound auscultation and analysis device. Respiratory sounds result from the intra-pulmonary collision of molecules contained in the air, leading to turbulent flow and subsequent sound production. These sounds have been recorded via an electronic stethoscope and analyzed using back-propagation neural networks, wavelet transform models, Gaussian mixture models and recently with machine learning and deep learning models with possible use in asthma, COVID-19, asbestosis and interstitial lung disease. The purpose of this review was to summarize lung sound physiology, recording technologies and diagnostics methods using AI for digital pulmonology practice. Future research and development in recording and analyzing respiratory sounds in real time could revolutionize clinical practice for both the patients and the healthcare personnel.
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Affiliation(s)
- Arshia K Sethi
- GIH Artificial Intelligence Laboratory (GAIL), Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Pratyusha Muddaloor
- GIH Artificial Intelligence Laboratory (GAIL), Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Joshika Agarwal
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Anmol Mohan
- GIH Artificial Intelligence Laboratory (GAIL), Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | | | - Keerthy Gopalakrishnan
- GIH Artificial Intelligence Laboratory (GAIL), Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
- Microwave Engineering and Imaging Laboratory (MEIL), Division of Gastroenterology & Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Ashima Yadav
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Aakriti Adhikari
- GIH Artificial Intelligence Laboratory (GAIL), Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Devanshi Damani
- Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN 55905, USA
- Department of Internal Medicine, Texas Tech University Health Science Center, El Paso, TX 79995, USA
| | - Kanchan Kulkarni
- INSERM, Centre de Recherche Cardio-Thoracique de Bordeaux, University of Bordeaux, U1045, F-33000 Bordeaux, France
- IHU Liryc, Heart Rhythm Disease Institute, Fondation Bordeaux Université, F-33600 Pessac, France
| | | | - Alexander J Ryu
- Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Vivek N Iyer
- Division of Pulmonary and Critical Care Medicine, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
| | - Shivaram P Arunachalam
- GIH Artificial Intelligence Laboratory (GAIL), Division of Gastroenterology and Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
- Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
- Department of Radiology, Mayo Clinic, Rochester, MN 55905, USA
- Microwave Engineering and Imaging Laboratory (MEIL), Division of Gastroenterology & Hepatology, Department of Medicine, Mayo Clinic, Rochester, MN 55905, USA
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A temporal dependency feature in lower dimension for lung sound signal classification. Sci Rep 2022; 12:7889. [PMID: 35551232 PMCID: PMC9098886 DOI: 10.1038/s41598-022-11726-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Accepted: 04/04/2022] [Indexed: 11/20/2022] Open
Abstract
Respiratory sounds are expressed as nonlinear and nonstationary signals, whose unpredictability makes it difficult to extract significant features for classification. Static cepstral coefficients such as Mel-frequency cepstral coefficients (MFCCs), have been used for classification of lung sound signals. However, they are modeled in high-dimensional hyperspectral space, and also lose temporal dependency information. Therefore, we propose shifted \documentclass[12pt]{minimal}
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\begin{document}$$\delta $$\end{document}δ-cepstral coefficients in lower-subspace (SDC-L) as a novel feature for lung sound classification. It preserves temporal dependency information of multiple frames nearby same to original SDC, and improves feature extraction by reducing the hyperspectral dimension. We modified EMD algorithm by adding a stopping rule to objectively select a finite number of intrinsic mode functions (IMFs). The performances of SDC-L were evaluated with three machine learning techniques (support vector machine (SVM), k-nearest neighbor (k-NN) and random forest (RF)) and two deep learning algorithms (multilayer perceptron (MLP) and convolutional neural network (cNN)) and one hybrid deep learning algorithm combining cNN with long short term memory (LSTM) in terms of accuracy, precision, recall and F1-score. We found that the first 2 IMFs were enough to construct our feature. SVM, MLP and a hybrid deep learning algorithm (cNN plus LSTM) outperformed with SDC-L, and the other classifiers achieved equivalent results with all features. Our findings show that SDC-L is a promising feature for the classification of lung sound signals.
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Nabi FG, Sundaraj K, Lam CK. Identification of asthma severity levels through wheeze sound characterization and classification using integrated power features. Biomed Signal Process Control 2019. [DOI: 10.1016/j.bspc.2019.04.018] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Ghulam Nabi F, Sundaraj K, Chee Kiang L, Palaniappan R, Sundaraj S. Wheeze sound analysis using computer-based techniques: a systematic review. ACTA ACUST UNITED AC 2019; 64:1-28. [PMID: 29087951 DOI: 10.1515/bmt-2016-0219] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2016] [Accepted: 08/24/2017] [Indexed: 11/15/2022]
Abstract
Wheezes are high pitched continuous respiratory acoustic sounds which are produced as a result of airway obstruction. Computer-based analyses of wheeze signals have been extensively used for parametric analysis, spectral analysis, identification of airway obstruction, feature extraction and diseases or pathology classification. While this area is currently an active field of research, the available literature has not yet been reviewed. This systematic review identified articles describing wheeze analyses using computer-based techniques on the SCOPUS, IEEE Xplore, ACM, PubMed and Springer and Elsevier electronic databases. After a set of selection criteria was applied, 41 articles were selected for detailed analysis. The findings reveal that 1) computerized wheeze analysis can be used for the identification of disease severity level or pathology, 2) further research is required to achieve acceptable rates of identification on the degree of airway obstruction with normal breathing, 3) analysis using combinations of features and on subgroups of the respiratory cycle has provided a pathway to classify various diseases or pathology that stem from airway obstruction.
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Affiliation(s)
- Fizza Ghulam Nabi
- School of Mechatronic Engineering, Universiti Malaysia Perlis (UniMAP), 02600 Arau, Perlis, Malaysia, Phone: +601111519452
| | - Kenneth Sundaraj
- Faculty of Electronics and Computer Engineering, Universiti Teknikal Malaysia Melaka (UTeM), 76100 Durian Tunggal, Melaka, Malaysia
| | - Lam Chee Kiang
- School of Mechatronic Engineering, Universiti Malaysia Perlis (UniMAP), 02600 Arau, Perlis, Malaysia
| | - Rajkumar Palaniappan
- School of Electronics Engineering, Vellore Institute of Technology (VIT), Tamil Nadu 632014, India
| | - Sebastian Sundaraj
- Department of Anesthesiology, Hospital Tengku Ampuan Rahimah (HTAR), 41200 Klang, Selangor, Malaysia
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Nabi FG, Sundaraj K, Lam CK, Palaniappan R. Analysis of wheeze sounds during tidal breathing according to severity levels in asthma patients. J Asthma 2019; 57:353-365. [PMID: 30810448 DOI: 10.1080/02770903.2019.1576193] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/27/2022]
Abstract
Objective: This study aimed to statistically analyze the behavior of time-frequency features in digital recordings of wheeze sounds obtained from patients with various levels of asthma severity (mild, moderate, and severe), and this analysis was based on the auscultation location and/or breath phase. Method: Segmented and validated wheeze sounds were collected from the trachea and lower lung base (LLB) of 55 asthmatic patients during tidal breathing maneuvers and grouped into nine different datasets. The quartile frequencies F25, F50, F75, F90 and F99, mean frequency (MF) and average power (AP) were computed as features, and a univariate statistical analysis was then performed to analyze the behavior of the time-frequency features. Results: All features generally showed statistical significance in most of the datasets for all severity levels [χ2 = 6.021-71.65, p < 0.05, η2 = 0.01-0.52]. Of the seven investigated features, only AP showed statistical significance in all the datasets. F25, F75, F90 and F99 exhibited statistical significance in at least six datasets [χ2 = 4.852-65.63, p < 0.05, η2 = 0.01-0.52], and F25, F50 and MF showed statistical significance with a large η2 in all trachea-related datasets [χ2 = 13.54-55.32, p < 0.05, η2 = 0.13-0.33]. Conclusion: The results obtained for the time-frequency features revealed that (1) the asthma severity levels of patients can be identified through a set of selected features with tidal breathing, (2) tracheal wheeze sounds are more sensitive and specific predictors of severity levels and (3) inspiratory and expiratory wheeze sounds are almost equally informative.
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Affiliation(s)
- Fizza Ghulam Nabi
- School of Mechatronic Engineering, Universiti Malaysia Perlis, Malaysia
| | - Kenneth Sundaraj
- Centre for Telecommunication Research & Innovation, Fakulti Kejuruteraan Elektronik & Kejuruteraan Komputer, Universiti Teknikal Malaysia Melaka, Malaysia
| | - Chee Kiang Lam
- School of Mechatronic Engineering, Universiti Malaysia Perlis, Malaysia
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Characterization and classification of asthmatic wheeze sounds according to severity level using spectral integrated features. Comput Biol Med 2018; 104:52-61. [PMID: 30439599 DOI: 10.1016/j.compbiomed.2018.10.035] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/20/2018] [Revised: 10/31/2018] [Accepted: 10/31/2018] [Indexed: 11/21/2022]
Abstract
OBJECTIVE This study aimed to investigate and classify wheeze sounds of asthmatic patients according to their severity level (mild, moderate and severe) using spectral integrated (SI) features. METHOD Segmented and validated wheeze sounds were obtained from auscultation recordings of the trachea and lower lung base of 55 asthmatic patients during tidal breathing manoeuvres. The segments were multi-labelled into 9 groups based on the auscultation location and/or breath phases. Bandwidths were selected based on the physiology, and a corresponding SI feature was computed for each segment. Univariate and multivariate statistical analyses were then performed to investigate the discriminatory behaviour of the features with respect to the severity levels in the various groups. The asthmatic severity levels in the groups were then classified using the ensemble (ENS), support vector machine (SVM) and k-nearest neighbour (KNN) methods. RESULTS AND CONCLUSION All statistical comparisons exhibited a significant difference (p < 0.05) among the severity levels with few exceptions. In the classification experiments, the ensemble classifier exhibited better performance in terms of sensitivity, specificity and positive predictive value (PPV). The trachea inspiratory group showed the highest classification performance compared with all the other groups. Overall, the best PPV for the mild, moderate and severe samples were 95% (ENS), 88% (ENS) and 90% (SVM), respectively. With respect to location, the tracheal related wheeze sounds were most sensitive and specific predictors of asthma severity levels. In addition, the classification performances of the inspiratory and expiratory related groups were comparable, suggesting that the samples from these locations are equally informative.
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Abstract
Recent developments in sensor technology and computational analysis methods enable new strategies to measure and interpret lung acoustic signals that originate internally, such as breathing or vocal sounds, or are externally introduced, such as in chest percussion or airway insonification. A better understanding of these sounds has resulted in a new instrumentation that allows for highly accurate as well as portable options for measurement in the hospital, in the clinic, and even at home. This review outlines the instrumentation for acoustic stimulation and measurement of the lungs. We first review the fundamentals of acoustic lung signals and the pathophysiology of the diseases that these signals are used to detect. Then, we focus on different methods of measuring and creating signals that have been used in recent research for pulmonary disease diagnosis. These new methods, combined with signal processing and modeling techniques, lead to a reduction in noise and allow improved feature extraction and signal classification. We conclude by presenting the results of human subject studies taking advantage of both the instrumentation and signal processing tools to accurately diagnose common lung diseases. This paper emphasizes the active areas of research within modern lung acoustics and encourages the standardization of future work in this field.
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Islam MA, Bandyopadhyaya I, Bhattacharyya P, Saha G. Multichannel lung sound analysis for asthma detection. COMPUTER METHODS AND PROGRAMS IN BIOMEDICINE 2018; 159:111-123. [PMID: 29650306 DOI: 10.1016/j.cmpb.2018.03.002] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/07/2017] [Revised: 02/25/2018] [Accepted: 03/09/2018] [Indexed: 06/08/2023]
Abstract
BACKGROUND AND OBJECTIVE Lung sound signals convey valuable information of the lung status. Auscultation is an effective technique to appreciate the condition of the respiratory system using lung sound signals. The prior works on asthma detection from lung sound signals rely on the presence of wheeze. In this paper, we have classified normal and asthmatic subjects using advanced signal processing of posterior lung sound signals, even in the absence of wheeze. METHODS We collected lung sounds of 60 subjects (30 normal and 30 asthma) using a novel 4-channel data acquisition system from four different positions over the posterior chest, as suggested by the pulmonologist. A spectral subband based feature extraction scheme is proposed that works with artificial neural network (ANN) and support vector machine (SVM) classifiers for the multichannel signal. The power spectral density (PSD) is estimated from extracted lung sound cycle using Welch's method, which then decomposed into uniform subbands. A set of statistical features is computed from each subband and applied to ANN and SVM classifiers to classify normal and asthmatic subjects. RESULTS In the first part of this study, the performances of each individual channel and four channels together are evaluated where the combined channel performance is found superior to that of individual channels. Next, the performances of all possible combinations of the channels are investigated and the best classification accuracies of 89.2( ± 3.87)% and 93.3( ± 3.10)% are achieved for 2-channel and 3-channel combinations in ANN and SVM classifiers, respectively. CONCLUSIONS The proposed multichannel asthma detection method where the presence of wheeze in lung sound is not a necessary requirement, outperforms commonly used lung sound classification methods in this field and provides significant relative improvement. The channel combination study gives insight into the contribution of respective lung sound collection areas and their combinations in asthma detection.
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Affiliation(s)
- Md Ariful Islam
- Department of Electronics and Electrical Communication Engineering, Indian Institute of Technology, Kharagpur, Kharagpur 721302, India.
| | - Irin Bandyopadhyaya
- Department of Electronics and Electrical Communication Engineering, Indian Institute of Technology, Kharagpur, Kharagpur 721302, India.
| | | | - Goutam Saha
- Department of Electronics and Electrical Communication Engineering, Indian Institute of Technology, Kharagpur, Kharagpur 721302, India.
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Shimoda T, Obase Y, Nagasaka Y, Kishikawa R, Mukae H, Iwanaga T. Peripheral bronchial obstruction evaluation in patients with asthma by lung sound analysis and impulse oscillometry. Allergol Int 2017; 66:132-138. [PMID: 27516132 DOI: 10.1016/j.alit.2016.06.008] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2016] [Revised: 05/23/2016] [Accepted: 06/20/2016] [Indexed: 11/15/2022] Open
Abstract
BACKGROUND Computer-aided lung sound analysis (LSA) has been reported to be useful for evaluating airway inflammation and obstruction in asthma patients. We investigated the relation between LSA and impulse oscillometry with the evaluation of peripheral airway obstruction. METHODS A total of 49 inhaled corticosteroid-naive bronchial asthma patients underwent LSA, spirometry, impulse oscillometry, and airway hyperresponsiveness testing. The data were analyzed to assess correlations between the expiration: inspiration lung sound power ratio (dB) at low frequencies between 100 and 195 Hz (E/I LF) and various parameters. RESULTS E/I LF and X5 were identified as independent factors that affect V˙50,%predicted. E/I LF showed a positive correlation with R5 (r = 0.34, p = 0.017), R20 (r = 0.34, p = 0.018), reactance area (AX, r = 0.40, p = 0.005), and resonant frequency of reactance (Fres, r = 0.32, p = 0.024). A negative correlation was found between E/I LF and X5 (r = -0.47, p = 0.0006). E/I LF showed a negative correlation with FEV1/FVC(%), FEV1,%predicted, V˙50,%predicted, and V˙25,%predicted (r = -0.41, p = 0.003; r = -0.44, p = 0.002; r = -0.49, p = 0.0004; and r = -0.30, p = 0.024, respectively). E/I LF was negatively correlated with log PC20 (r = -0.30, p = 0.024). Log PC20, X5, and past smoking were identified as independent factors that affected E/I LF level. CONCLUSIONS E/I LF as with X5 can be an indicator of central and peripheral airway obstruction in bronchial asthma patients.
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Affiliation(s)
- Terufumi Shimoda
- Clinical Research Center, Fukuoka National Hospital, Fukuoka, Japan.
| | - Yasushi Obase
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | | | - Reiko Kishikawa
- Clinical Research Center, Fukuoka National Hospital, Fukuoka, Japan
| | - Hiroshi Mukae
- Department of Respiratory Medicine, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan
| | - Tomoaki Iwanaga
- Clinical Research Center, Fukuoka National Hospital, Fukuoka, Japan
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Sengupta N, Sahidullah M, Saha G. Lung sound classification using cepstral-based statistical features. Comput Biol Med 2016; 75:118-29. [PMID: 27286184 DOI: 10.1016/j.compbiomed.2016.05.013] [Citation(s) in RCA: 49] [Impact Index Per Article: 6.1] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/12/2016] [Revised: 05/18/2016] [Accepted: 05/20/2016] [Indexed: 11/16/2022]
Affiliation(s)
- Nandini Sengupta
- Department of Electronics and Electrical Communication Engineering, Indian Institute of Technology, Kharagpur, Kharagpur 721302, India.
| | - Md Sahidullah
- Speech and Image Processing Unit, School of Computing, University of Eastern Finland, Joensuu 80101, Finland.
| | - Goutam Saha
- Department of Electronics and Electrical Communication Engineering, Indian Institute of Technology, Kharagpur, Kharagpur 721302, India.
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Mazić I, Bonković M, Džaja B. Two-level coarse-to-fine classification algorithm for asthma wheezing recognition in children's respiratory sounds. Biomed Signal Process Control 2015. [DOI: 10.1016/j.bspc.2015.05.002] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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Palaniappan R, Sundaraj K, Sundaraj S. Artificial intelligence techniques used in respiratory sound analysis--a systematic review. ACTA ACUST UNITED AC 2015; 59:7-18. [PMID: 24114889 DOI: 10.1515/bmt-2013-0074] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/19/2012] [Accepted: 08/30/2013] [Indexed: 11/15/2022]
Abstract
Artificial intelligence (AI) has recently been established as an alternative method to many conventional methods. The implementation of AI techniques for respiratory sound analysis can assist medical professionals in the diagnosis of lung pathologies. This article highlights the importance of AI techniques in the implementation of computer-based respiratory sound analysis. Articles on computer-based respiratory sound analysis using AI techniques were identified by searches conducted on various electronic resources, such as the IEEE, Springer, Elsevier, PubMed, and ACM digital library databases. Brief descriptions of the types of respiratory sounds and their respective characteristics are provided. We then analyzed each of the previous studies to determine the specific respiratory sounds/pathology analyzed, the number of subjects, the signal processing method used, the AI techniques used, and the performance of the AI technique used in the analysis of respiratory sounds. A detailed description of each of these studies is provided. In conclusion, this article provides recommendations for further advancements in respiratory sound analysis.
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Shimoda T, Nagasaka Y, Obase Y, Kishikawa R, Iwanaga T. Prediction of airway inflammation in patients with asymptomatic asthma by using lung sound analysis. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2014; 2:727-32. [PMID: 25439364 DOI: 10.1016/j.jaip.2014.06.017] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Received: 01/05/2014] [Revised: 06/29/2014] [Accepted: 06/30/2014] [Indexed: 10/24/2022]
Abstract
BACKGROUND The intensity and frequency of sounds in a lung sound analysis (LSA) may be related to airway constriction; however, whether any factors of an LSA can predict airway eosinophilic inflammation in patients with asthma is unknown. OBJECTIVE To determine whether an LSA can predict airway eosinophilic inflammation in patients with asymptomatic asthma. METHODS The expiratory-inspiratory ratios of sound power in the low-frequency range (E-I LF) from 36 patients with asymptomatic asthma were compared with those of 14 healthy controls. The relations of E-I LF with airway eosinophilic inflammation were analyzed. The E-I LF cutoff value for predicting airway eosinophilic inflammation also was analyzed. RESULTS The mean ± SD E-I LF was higher in the patients with asthma and with increased sputum eosinophils than in those patients without increased sputum eosinophils (0.45 ± 0.24 vs 0.20 ± 0.12; P < .001) or in the healthy controls (0.25 ± 0.10; P = .003). A multiple regression analysis showed that the sputum eosinophil ratio and exhaled nitric oxide were independently correlated with E-I LF, P = .0003 and P = .032, respectively. For the prediction of increased sputum eosinophils and increased fractional exhaled nitric oxide levels, the E-I LF thresholds of 0.29 and 0.30 showed sensitivities of 0.80 and 0.74 and specificities of 0.83 and 0.77, respectively. CONCLUSIONS We showed that LSAs can safely predict airway inflammation of patients with asymptomatic asthma.
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Affiliation(s)
- Terufumi Shimoda
- Clinical Research Center, Fukuoka National Hospital, Fukuoka, Japan.
| | | | - Yasushi Obase
- Department of Respiratory Medicine, Kawasaki Medical School, Kurashiki, Okayama, Japan
| | - Reiko Kishikawa
- Clinical Research Center, Fukuoka National Hospital, Fukuoka, Japan
| | - Tomoaki Iwanaga
- Clinical Research Center, Fukuoka National Hospital, Fukuoka, Japan
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Rhee H, Miner S, Sterling M, Halterman JS, Fairbanks E. The development of an automated device for asthma monitoring for adolescents: methodologic approach and user acceptability. JMIR Mhealth Uhealth 2014; 2:e27. [PMID: 25100184 PMCID: PMC4114416 DOI: 10.2196/mhealth.3118] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2013] [Revised: 03/23/2014] [Accepted: 04/27/2014] [Indexed: 11/29/2022] Open
Abstract
BACKGROUND Many adolescents suffer serious asthma related morbidity that can be prevented by adequate self-management of the disease. The accurate symptom monitoring by patients is the most fundamental antecedent to effective asthma management. Nonetheless, the adequacy and effectiveness of current methods of symptom self-monitoring have been challenged due to the individuals' fallible symptom perception, poor adherence, and inadequate technique. Recognition of these limitations led to the development of an innovative device that can facilitate continuous and accurate monitoring of asthma symptoms with minimal disruption of daily routines, thus increasing acceptability to adolescents. OBJECTIVE The objectives of this study were to: (1) describe the development of a novel symptom monitoring device for teenagers (teens), and (2) assess their perspectives on the usability and acceptability of the device. METHODS Adolescents (13-17 years old) with and without asthma participated in the evolution of an automated device for asthma monitoring (ADAM), which comprised three phases, including development (Phase 1, n=37), validation/user acceptability (Phase 2, n=84), and post hoc validation (Phase 3, n=10). In Phase 1, symptom algorithms were identified based on the acoustic analysis of raw symptom sounds and programmed into a popular mobile system, the iPod. Phase 2 involved a 7 day trial of ADAM in vivo, and the evaluation of user acceptance using an acceptance survey and individual interviews. ADAM was further modified and enhanced in Phase 3. RESULTS Through ADAM, incoming audio data were digitized and processed in two steps involving the extraction of a sequence of descriptive feature vectors, and the processing of these sequences by a hidden Markov model-based Viterbi decoder to differentiate symptom sounds from background noise. The number and times of detected symptoms were stored and displayed in the device. The sensitivity (true positive) of the updated cough algorithm was 70% (21/30), and, on average, 2 coughs per hour were identified as false positive. ADAM also kept track of the their activity level throughout the day using the mobile system's built in accelerometer function. Overall, the device was well received by participants who perceived it as attractive, convenient, and helpful. The participants recognized the potential benefits of the device in asthma care, and were eager to use it for their asthma management. CONCLUSIONS ADAM can potentially automate daily symptom monitoring with minimal intrusiveness and maximal objectivity. The users' acceptance of the device based on its recognized convenience, user-friendliness, and usefulness in increasing symptom awareness underscores ADAM's potential to overcome the issues of symptom monitoring including poor adherence, inadequate technique, and poor symptom perception in adolescents. Further refinement of the algorithm is warranted to improve the accuracy of the device. Future study is also needed to assess the efficacy of the device in promoting self-management and asthma outcomes.
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Affiliation(s)
- Hyekyun Rhee
- University of Rochester Medical Center, School of Nursing, University of Rochester, Rochester, NY, United States.
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Gurung A, Scrafford CG, Tielsch JM, Levine OS, Checkley W. Computerized lung sound analysis as diagnostic aid for the detection of abnormal lung sounds: a systematic review and meta-analysis. Respir Med 2011; 105:1396-403. [PMID: 21676606 DOI: 10.1016/j.rmed.2011.05.007] [Citation(s) in RCA: 99] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2011] [Revised: 05/09/2011] [Accepted: 05/11/2011] [Indexed: 10/18/2022]
Abstract
RATIONALE The standardized use of a stethoscope for chest auscultation in clinical research is limited by its inherent inter-listener variability. Electronic auscultation and automated classification of recorded lung sounds may help prevent some of these shortcomings. OBJECTIVE We sought to perform a systematic review and meta-analysis of studies implementing computerized lung sound analysis (CLSA) to aid in the detection of abnormal lung sounds for specific respiratory disorders. METHODS We searched for articles on CLSA in MEDLINE, EMBASE, Cochrane Library and ISI Web of Knowledge through July 31, 2010. Following qualitative review, we conducted a meta-analysis to estimate the sensitivity and specificity of CLSA for the detection of abnormal lung sounds. MEASUREMENTS AND MAIN RESULTS Of 208 articles identified, we selected eight studies for review. Most studies employed either electret microphones or piezoelectric sensors for auscultation, and Fourier Transform and Neural Network algorithms for analysis and automated classification of lung sounds. Overall sensitivity for the detection of wheezes or crackles using CLSA was 80% (95% CI 72-86%) and specificity was 85% (95% CI 78-91%). CONCLUSIONS While quality data on CLSA are relatively limited, analysis of existing information suggests that CLSA can provide a relatively high specificity for detecting abnormal lung sounds such as crackles and wheezes. Further research and product development could promote the value of CLSA in research studies or its diagnostic utility in clinical settings.
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Affiliation(s)
- Arati Gurung
- Division of Pulmonary and Critical Care, School of Medicine, Johns Hopkins University, Baltimore, MD 21205, USA
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Zolnoori M, Zarandi MHF, Moin M. Application of intelligent systems in asthma disease: designing a fuzzy rule-based system for evaluating level of asthma exacerbation. J Med Syst 2011; 36:2071-83. [PMID: 21399914 DOI: 10.1007/s10916-011-9671-8] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/04/2010] [Accepted: 02/21/2011] [Indexed: 12/12/2022]
Abstract
This paper discusses the capacities of artificial intelligence in the process of asthma diagnosing and asthma treatment. Developed intelligent systems for asthma disease have been classified in five categories including diagnosing, evaluating, management, communicative facilities, and prediction. Considering inputs, results, and methodologies of the systems show that by focusing on meticulous analysis of quality of life as an input variable and developing patient-based systems, under-diagnosing and asthma morbidity and mortality would decrease significantly. Regard to the importance of accurate evaluation in accurate prescription and expeditious treatment, the methodology of developing a fuzzy expert system for evaluating level of asthma exacerbation is presented in this paper too. The performance of this system has been tested in Asthma, Allergy, and Immunology Center of Iran using 25 asthmatic patients. Comparison between system's results and physicians' evaluations using Kappa coefficient (K) reinforces the value of K = 1. In addition this system assigns a degree in gradation (0-10) to every patient representing the slight differences between patients assigned to a specific category.
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Aydore S, Sen I, Kahya YP, Mihcak M. Classification of respiratory signals by linear analysis. ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL INTERNATIONAL CONFERENCE 2010; 2009:2617-20. [PMID: 19965225 DOI: 10.1109/iembs.2009.5335395] [Citation(s) in RCA: 25] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Subscribe] [Scholar Register] [Indexed: 11/07/2022]
Abstract
The aim of this study is the classification of wheeze and non-wheeze epochs within respiratory sound signals acquired from patients with asthma and COPD. Since a wheeze signal, having a sinusoidal waveform, has a different behavior in time and frequency domains from that of a non-wheeze signal, the features selected for classification are kurtosis, Renyi entropy, f(50)/ f(90) ratio and mean-crossing irregularity. Upon calculation of these features for each wheeze and non-wheeze portion, the whole data scattered as two classes in four dimensional feature space is projected using Fisher Discriminant Analysis (FDA) onto the single dimensional space that separates the two classes best. Observing that the two classes are visually well separated in this new space, Neyman-Pearson hypothesis testing is applied. Finally, the correct classification rate is %95.1 for the training set, and leave-one-out approach pursuing the above methodology yields a success rate of %93.5 for the test set.
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Bahoura M. Pattern recognition methods applied to respiratory sounds classification into normal and wheeze classes. Comput Biol Med 2009; 39:824-43. [PMID: 19631934 DOI: 10.1016/j.compbiomed.2009.06.011] [Citation(s) in RCA: 88] [Impact Index Per Article: 5.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/14/2007] [Revised: 06/10/2009] [Accepted: 06/26/2009] [Indexed: 11/19/2022]
Abstract
In this paper, we present the pattern recognition methods proposed to classify respiratory sounds into normal and wheeze classes. We evaluate and compare the feature extraction techniques based on Fourier transform, linear predictive coding, wavelet transform and Mel-frequency cepstral coefficients (MFCC) in combination with the classification methods based on vector quantization, Gaussian mixture models (GMM) and artificial neural networks, using receiver operating characteristic curves. We propose the use of an optimized threshold to discriminate the wheezing class from the normal one. Also, post-processing filter is employed to considerably improve the classification accuracy. Experimental results show that our approach based on MFCC coefficients combined to GMM is well adapted to classify respiratory sounds in normal and wheeze classes. McNemar's test demonstrated significant difference between results obtained by the presented classifiers (p<0.05).
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Affiliation(s)
- Mohammed Bahoura
- Department of Engineering, University of Quebec at Rimouski, allée des Ursulines, Que., Canada.
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Dokur Z. Respiratory sound classification by using an incremental supervised neural network. Pattern Anal Appl 2008. [DOI: 10.1007/s10044-008-0125-y] [Citation(s) in RCA: 41] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
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Bahoura M, Pelletier C. Respiratory sounds classification using cepstral analysis and Gaussian mixture models. CONFERENCE PROCEEDINGS : ... ANNUAL INTERNATIONAL CONFERENCE OF THE IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. IEEE ENGINEERING IN MEDICINE AND BIOLOGY SOCIETY. ANNUAL CONFERENCE 2007; 2006:9-12. [PMID: 17271590 DOI: 10.1109/iembs.2004.1403077] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/08/2022]
Abstract
The Cepstral analysis is proposed with Gaussian Mixture Models (GMM) method to classify respiratory sounds in two categories: normal and wheezing. The sound signal is divided in overlapped segments, which are characterized by a reduced dimension feature vectors using Mel-Frequency Cepstral Coefficients (MFCC) or subband based Cepstral parameters (SBC). The proposed schema is compared with other classifiers: Vector Quantization (VQ) and Multi-Layer Perceptron (MLP) neural networks. A post processing is proposed to improve the classification results.
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Affiliation(s)
- M Bahoura
- Département de Mathématiques, d'Informatique et de Génie, Université du Québec à Rimouski, Que., Canada
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Sanders DL, Aronsky D. Biomedical informatics applications for asthma care: a systematic review. J Am Med Inform Assoc 2006; 13:418-27. [PMID: 16622164 PMCID: PMC1513670 DOI: 10.1197/jamia.m2039] [Citation(s) in RCA: 30] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/10/2022] Open
Abstract
Asthma is a common condition associated with significant patient morbidity and health care costs. Although widely accepted evidence-based guidelines for asthma management exist, unnecessary variation in patient care remains. Application of biomedical informatics techniques is one potential way to improve care for asthmatic patients. We performed a systematic literature review to identify computerized applications for clinical asthma care. Studies were evaluated for their clinical domain, developmental stage and study design. Additionally, prospective trials were identified and analyzed for potential study biases, study effects, and clinical study characteristics. Sixty-four papers were selected for review. Publications described asthma detection or diagnosis (18 papers), asthma monitoring or prevention (13 papers), patient education (13 papers), and asthma guidelines or therapy (20 papers). The majority of publications described projects in early stages of development or with non-prospective study designs. Twenty-one prospective trials were identified, which evaluated both clinical and non-clinical impacts on patient care. Most studies took place in the outpatient clinic environment, with minimal study of the emergency department or inpatient settings. Few studies demonstrated evidence of computerized applications improving clinical outcomes. Further research is needed to prospectively evaluate the impact of using biomedical informatics to improve care of asthmatic patients.
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Affiliation(s)
- David L. Sanders
- Department of Biomedical Informatics, Vanderbilt University Medical Center, Nashville, TN
| | - Dominik Aronsky
- Department of Emergency Medicine, Vanderbilt University Medical Center, Nashville, TN
- Correspondence and reprints: Dominik Aronsky, MD, PhD, Dept. of Biomedical Informatics, Eskind Biomedical Library, Vanderbilt University Medical Center, 2209 Garland Ave, Nashville, TN 37232-8340 ()
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Güler I, Polat H, Ergün U. Combining neural network and genetic algorithm for prediction of lung sounds. J Med Syst 2005; 29:217-31. [PMID: 16050077 DOI: 10.1007/s10916-005-5182-9] [Citation(s) in RCA: 36] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
Abstract
Recognition of lung sounds is an important goal in pulmonary medicine. In this work, we present a study for neural networks-genetic algorithm approach intended to aid in lung sound classification. Lung sound was captured from the chest wall of The subjects with different pulmonary diseases and also from the healthy subjects. Sound intervals with duration of 15-20 s were sampled from subjects. From each interval, full breath cycles were selected. Of each selected breath cycle, a 256-point Fourier Power Spectrum Density (PSD) was calculated. Total of 129 data values calculated by the spectral analysis are selected by genetic algorithm and applied to neural network. Multilayer perceptron (MLP) neural network employing backpropagation training algorithm was used to predict the presence or absence of adventitious sounds (wheeze and crackle). We used genetic algorithms to search for optimal structure and training parameters of neural network for a better predicting of lung sounds. This application resulted in designing of optimum network structure and, hence reducing the processing load and time.
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Affiliation(s)
- Inan Güler
- Department of Electronic and Computer Education, Faculty of Technical Education, Gazi University, 06500 Teknikokullar, Ankara, Turkey.
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Kandaswamy A, Kumar CSCS, Ramanathan RP, Jayaraman S, Malmurugan N. Neural classification of lung sounds using wavelet coefficients. Comput Biol Med 2004; 34:523-37. [PMID: 15265722 DOI: 10.1016/s0010-4825(03)00092-1] [Citation(s) in RCA: 133] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2003] [Accepted: 07/16/2003] [Indexed: 11/17/2022]
Abstract
Electronic auscultation is an efficient technique to evaluate the condition of respiratory system using lung sounds. As lung sound signals are non-stationary, the conventional method of frequency analysis is not highly successful in diagnostic classification. This paper deals with a novel method of analysis of lung sound signals using wavelet transform, and classification using artificial neural network (ANN). Lung sound signals were decomposed into the frequency subbands using wavelet transform and a set of statistical features was extracted from the subbands to represent the distribution of wavelet coefficients. An ANN based system, trained using the resilient back propagation algorithm, was implemented to classify the lung sounds to one of the six categories: normal, wheeze, crackle, squawk, stridor, or rhonchus.
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Affiliation(s)
- A Kandaswamy
- Department of Electronics and Communication Engineering, PSG College of Technology, Coimbatore-641 004, India
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Folland R, Hines E, Dutta R, Boilot P, Morgan D. Comparison of neural network predictors in the classification of tracheal-bronchial breath sounds by respiratory auscultation. Artif Intell Med 2004; 31:211-20. [PMID: 15302087 DOI: 10.1016/j.artmed.2004.01.004] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2003] [Revised: 11/06/2003] [Accepted: 01/17/2004] [Indexed: 11/28/2022]
Abstract
Despite extensive research in the area of identification and discrimination of tracheal-bronchial breath sounds by computer analysis, the process of identifying auscultated sounds is still subject to high estimation uncertainties. Here we assess the performance of the relatively new constructive probabilistic neural network (CPNN) against the more common classifiers, namely the multilayer perceptron (MLP) and radial basis function network (RBFN), in classifying a broad range of tracheal-bronchial breath sounds. We present our data as signal estimation models of the tracheal-bronchial frequency spectra. We have examined the trained structure of the CPNN with respect to the other architectures and conclude that this architecture offers an attractive means with which to analyse this type of data. This is based partly on the classification accuracies attained by the CPNN, MLP and RBFN which were 97.8, 77.8 and 96.2%, respectively. We concluded that CPNN and RBFN networks are capable of working successfully with this data, with these architectures being acceptable in terms of topological size and computational overhead requirements. We further believe that the CPNN is an attractive classification mechanism for auscultated data analysis due to its optimal data model generation properties and computationally lightweight architecture.
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Affiliation(s)
- Ross Folland
- Intelligent Systems Engineering Laboratory, Electrical and Electronics Division, School of Engineering, University of Warwick, Coventry CV4 7AL, UK.
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