Can Acute Cough Characteristics From Sound Recordings Differentiate Common Respiratory Illnesses in Children?: A Comparative Prospective Study

The value of the wireless stethoscope in patients with COVID-19 infection in a makeshift hospital

OBJECTIVE

When COVID-19 sweeps the world, traditional stethoscopes are seen as infectious agents and then the use of stethoscopes is limited especially when health providers were in their personal protective equipment. These reasons led to the ignoring of the values of stethoscopes during pandemics. This study aims to explore the value of wireless stethoscopes in patients of a makeshift hospital.

MATERIAL AND METHODS

200 consecutive hospitalized patients with confirmed SARS-CoV-2 at Lingang Makeshift Hospital in Shanghai, China, were enrolled from April 10 to May 10, 2022 (Trial Registration Number: ChiCTR2000038272,2020/9/15). They were randomly divided into two groups. In group A (n = 100), patients were examined without a stethoscope. In group B (n = 100), lung breath sounds and heart sounds were examined with a wireless stethoscope, and positive signs were recorded. The duration of cough and tachycardia symptoms, as well as emergency cases, were compared between the two groups. In addition, the pressure, anxiety, and depression of patients in the two groups were investigated using the DAS-21 questionnaire scale, to observe the psychological impact of the stethoscope-based doctor-patient communication on patients in the makeshift hospital.

RESULTS

There was no significant difference in baseline characteristics between the two groups. In group B, some significant positive signs were detected by wireless stethoscopes, including pulmonary rales and tachycardia, etc. Moreover, the therapeutic measures based on these positive signs effectively alleviated the symptoms of cough and tachycardia, which showed that the duration of symptoms was significantly shorter than that of group A (cough: 2.8 ± 0.9 vs. 3.6 ± 0.9; palpitation: 1.4 ± 0.7 vs. 2.6 ± 0.7). In particular, the number of emergency cases in group B is less than that in group A (1% vs. 3%), and the severity is lower. Notably, stethoscope-based doctor-patient communication was found to be effective in alleviating psychological measures of group B patients.

CONCLUSION

Wireless stethoscopes in makeshift hospitals can avoid cross-infections and detect more valuable positive signs, which can help health providers make accurate decisions and relieve patients' symptoms more quickly. Moreover, stethoscope-based doctor-patient communication can diminish the psychological impacts of the epidemic on isolated patients in makeshift hospitals. Trial registration This study was registered in the Chinese Clinical Trial (ChiCTR2000038272) at http://www.chictr.org.cn . http://www.chinadrugtrials.org.cn/clinicaltrials.searchlistdetail.dhtml .

Smart Devices Are Poised to Revolutionize the Usefulness of Respiratory Sounds

The association between breathing sounds and respiratory health or disease has been exceptionally useful in the practice of medicine since the advent of the stethoscope. Remote patient monitoring technology and artificial intelligence offer the potential to develop practical means of assessing respiratory function or dysfunction through continuous assessment of breathing sounds when patients are at home, at work, or even asleep. Automated reports such as cough counts or the percentage of the breathing cycles containing wheezes can be delivered to a practitioner via secure electronic means or returned to the clinical office at the first opportunity. This has not previously been possible. The four respiratory sounds that most lend themselves to this technology are wheezes, to detect breakthrough asthma at night and even occupational asthma when a patient is at work; snoring as an indicator of OSA or adequacy of CPAP settings; cough in which long-term recording can objectively assess treatment adequacy; and crackles, which, although subtle and often overlooked, can contain important clinical information when appearing in a home recording. In recent years, a flurry of publications in the engineering literature described construction, usage, and testing outcomes of such devices. Little of this has appeared in the medical literature. The potential value of this technology for pulmonary medicine is compelling. We expect that these tiny, smart devices soon will allow us to address clinical questions that occur away from the clinic.

A classification framework for identifying bronchitis and pneumonia in children based on a small-scale cough sounds dataset

Bronchitis and pneumonia are the common respiratory diseases, of which pneumonia is the leading cause of mortality in pediatric patients worldwide and impose intense pressure on health care systems. This study aims to classify bronchitis and pneumonia in children by analyzing cough sounds. We propose a Classification Framework based on Cough Sounds (CFCS) to identify bronchitis and pneumonia in children. Our dataset includes cough sounds from 173 outpatients at the West China Second University Hospital, Sichuan University, Chengdu, China. We adopt aggregation operation to obtain patients’ disease features because some cough chunks carry the disease information while others do not. In the stage of classification in our framework, we adopt Support Vector Machine (SVM) to classify the diseases due to the small scale of our dataset. Furthermore, we apply data augmentation to our dataset to enlarge the number of samples and then adopt Long Short-Term Memory Network (LSTM) to classify. After 45 random tests on RAW dataset, SVM achieves the best classification accuracy of 86.04% and standard deviation of 4.7%. The precision of bronchitis and pneumonia is 93.75% and 87.5%, and their recall is 88.24% and 93.33%. The AUC of SVM and LSTM classification models on the dataset with pitch-shifting data augmentation reach 0.92 and 0.93, respectively. Extensive experimental results show that CFCS can effectively classify children into bronchitis and pneumonia.